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首页> 外文期刊>Blood Pressure Monitoring >Linking clinic and home: A randomized, controlled clinical effectiveness trial of real-time, wireless blood pressure monitoring for older patients with kidney disease and hypertension
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Linking clinic and home: A randomized, controlled clinical effectiveness trial of real-time, wireless blood pressure monitoring for older patients with kidney disease and hypertension

机译：连接诊所和家庭：针对老年肾脏疾病和高血压患者进行实时无线无线血压监测的随机对照临床疗效试验

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OBJECTIVE: Older adults with chronic kidney disease have a high rate of uncontrolled hypertension. Home monitoring of blood pressure (BP) is an integral part of management, but requires that patients bring records to clinic visits. Telemonitoring interventions, however, have not targeted older, less technologically-skilled populations. METHODS: Veterans with stage 3 or greater chronic kidney disease and uncontrolled hypertension were randomized to a novel telemonitoring device pairing a Bluetooth-enabled BP cuff with an Internet-enabled hub, which wirelessly transmitted readings (n=28), or usual care (n=15). Home recordings were reviewed weekly and telemonitoring participants were contacted if BP was above goal. The prespecified primary endpoints were improved data exchange and device acceptability. Secondary endpoint was BP change. RESULTS: Forty-three participants (average age 68 years, 75% white) completed the 6-month study. Average start-of-study BP was 147/78 mmHg. Those in the intervention arm had a median of 29 (IQR 22, 53) transmitted BP readings per month, with 78% continuing to use the device regularly, whereas only 20% of those in the usual care group brought readings to in-person visits. The median number of telephone contacts triggered by the wireless monitoring was 2 (IQR 1, 4) per patient. Both groups had a significant improvement in systolic BP (P<0.05, for both changes); systolic BP fell a median of 13 mmHg in monitored participants compared with 8.5 mmHg in usual care participants (P for comparison 0.31). CONCLUSION: This low-cost wireless monitoring strategy led to greater sharing of data between patients and clinic and produced a trend toward improvements in BP control over usual care at 6 months.
机译：目的：患有慢性肾脏疾病的老年人患有高度无法控制的高血压。家庭血压（BP）的家庭监测是管理的组成部分，但要求患者将记录带到诊所就诊。但是，远程监视干预并未针对年龄较小，技术水平较低的人群。方法：将患有3期或更严重的慢性肾脏疾病和高血压不受控制的退伍军人随机分配到一种新型远程监控设备，该设备将蓝牙BP袖带与互联网集线器配对，以无线方式传输读数（n = 28）或常规护理（n = 15）。每周检查一次家庭录音，如果BP超出目标，则联系远程监控参与者。预先指定的主要终点是改善的数据交换和设备可接受性。次要终点是血压变化。结果：43名参与者（平均年龄68岁，白人占75％）完成了为期6个月的研究。平均研究血压为147/78 mmHg。干预组中的患者每月平均有29次（IQR 22，53）传输BP读数，其中78％的人继续定期使用该设备，而常规护理组中只有20％的人亲自进行了读数。无线监控触发的电话联系的中位数为每位患者2（IQR 1、4）。两组的收缩压都有显着改善（两种变化均P <0.05）;监测参与者的收缩压中位数下降了13 mmHg，而常规护理参与者的收缩压下降了8.5 mmHg（P为比较0.31）。结论：这种低成本的无线监控策略导致患者和诊所之间更大程度的数据共享，并且在6个月的常规护理上产生了改善BP控制的趋势。

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