Web-based care and at-home blood pressure checks can help control hypertension without office visits, according to the "e-BP" (Electronic Blood Pressure) study of more than 700 Group Health patients published in the June 25 Journal of the American Medical Association.
"To our knowledge, this is the first large randomized controlled trial to use Web-based care and a patient-shared electronic medical record to improve treatment outcomes of a chronic disease," said study leader Beverly B. Green, MD, MPH, a family doctor and researcher at Group Health, a Seattle-based nonprofit health system coordinating care and coverage. "We shifted health care from the doctor's office to where people live: in their homesand online," she added.
Web-based care nearly doubled the percentage of people whose blood pressure was controlled (under 140/90 mm Hg), Dr. Green said. "And in the people with the highest blood pressure (at least 160 mm Hg systolic), who are usually hardest to treat, this Web-based care nearly tripled the proportion whose hypertension was under control."
Eligible Group Health patients with uncontrolled hypertension and Internet access were randomly assigned to groups. One group got home monitors to track their own blood pressureand care from pharmacists over a secure Web site. On e-mail, pharmacists helped patients set lifestyle goals and also followed standard guidelines to boost doses, switch, and combine hypertension drugs. "Secure e-mail communication made it easier for the health care team to work closely with patients to improve care," Dr. Green said.
The comparison group got usual care. At Group Health that includes a secure Web site where patients and health teams share access to electronic medical records. "By identifying and contacting the patients in usual care, and telling them to work with their doctors to control their blood pressure, we helped get many of those patients under control," Dr. Green said. "Th
|Contact: Rebecca Hughes|
Group Health Cooperative Center for Health Studies