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Blood pressure control in a hypertension telemedicine intervention: Does distance to primary care matter?

机译:高血压远程医疗干预中的血压控制:与初级保健的距离重要吗?

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Although telemedicine may help overcome geographic access barriers, it is unknown whether rural patients receive greater benefits. In a secondary analysis of 503 veterans participating in a hypertension telemedicine study, the authors hypothesized that patients with greater travel distances would have greater improvements in 18-month systolic blood pressure (SBP). Patients were categorized by telemedicine exposure and travel distance to primary care, derived from zip codes. Comparisons were (1) usual care (UC), distance <30 miles (reference); (2) UC, distance ≥30 miles; (3) telemedicine, distance <30 miles; (4) telemedicine, distance ≥30 miles. Compared with patients receiving UC, distance <30 miles (intercept=127.7), no difference in 18-month SBP was observed in patients receiving UC, distance ≥30 miles (0.13 mm Hg, 95% confidence interval [-6.6 to 6.8]); telemedicine, distance <30 miles (-1.1 mm Hg [-7.3 to 5.2]); telemedicine, distance ≥30 miles (-0.80 mm Hg [-6.6 to 5.1]). Although telemedicine may help overcome geographic access barriers, additional studies are needed to identify patients most likely to benefit.
机译:尽管远程医疗可以帮助克服地理上的障碍,但尚不清楚农村患者是否能获得更大的收益。在对参与高血压远程医疗研究的503例退伍军人进行的次要分析中,作者假设行进距离较远的患者18个月的收缩压(SBP)会有更大的改善。根据远程医疗的暴露程度以及从邮政编码获得的初级保健旅行距离对患者进行分类。比较为(1)常规护理(UC),距离<30英里(参考); (2)UC,距离≥30英里; (3)远程医疗,距离<30英里; (4)远程医疗,距离≥30英里。与接受UC,距离<30英里(截距= 127.7)的患者相比,接受UC,距离≥30英里(0.13 mm Hg,95%置信区间[-6.6至6.8])的患者在18个月SBP中没有观察到差异;远程医疗,距离<30英里(-1.1毫米汞柱[-7.3至5.2]);远程医疗,距离≥30英里(-0.80毫米汞柱[-6.6至5.1])。尽管远程医疗可能有助于克服地理上的障碍,但仍需要进行其他研究来确定最有可能受益的患者。

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