Compare the Effects of Telemedicine Approach With Usual Care in Hypertension Management in China

Phase

N/A

Condition

Vascular Diseases

Williams Syndrome

Circulation Disorders

Treatment

N/A

Clinical Study ID

NCT02919033

SHDC12015308

Ages > 21
All Genders

Study Summary

This three arm study is to compare the effects of a coordinated PCP-Cardiologist Telemedicine Model (PCTM) with usual care and self-care in community hypertension management in China.

Eligibility Criteria

Inclusion

Inclusion Criteria:

age 21 years or older
a clinical diagnosis of hypertension with uncontrolled BP in the previous threemonths, currently taking or about to take anti-hypertensive medications
received high school or above level of education
active user of smart phone (Android or Apple) and mobile Apps
the average of three BP measurements during the screening visit at the CHC is ≥ 140/90mm Hg, or ≥ 130/80 mm Hg if the patient has diabetes or renal diseases;
being able to give informed consent.

Exclusion

Exclusion Criteria:

acute coronary syndrome
heart failure
cardiac arrhythmia
stroke within the past three months
renal failure
cancer
dementia, severe or acute psychiatric illness, pregnancy or intention to be pregnantin the next 18 months, and hospitalization within 3 months.
additional exclusion criteria include participation in another clinical trial, arm
circumference >32 centimeters that may affect the accuracy of BP measurement due tocuff size limit of the tele-monitor's, and unwillingness to comply with the 12 monthintervention duration.

Study Design

September 01, 2016

August 31, 2018

Study Description

Background: Hypertension is a major risk factor for cardiovascular diseases and its control rate has remained low worldwide. Studies have found that telemonitoring blood pressure (BP) helped control hypertension in randomized controlled trials. However, little is known about its effect in a structured primary care model in which primary care physicians (PCP) are partnering with cardiology specialists in electronic healthcare data sharing and medical interventions. This study aims to identify the effects of a coordinated PCP-Cardiologist model that applies telemedicine tools to facilitate community hypertension control in China.

Methods/Design: Hypertensive patients receiving care at four community healthcare centers (CHCs) that are academically affiliated to Shanghai Chest Hospital, Shanghai JiaoTong University are eligible if they have uncontrolled blood pressure in the previous three months and access to mobile internet. Study subjects are randomly assigned to three interventional groups: 1) usual care; 2) home-based BP tele-monitor with embedded GSM module and unlimited data plan, an App to access personal healthcare record and receive personalized lifestyle coaching contents, and proficiency training of their use; or 3) this plus coordinated PCP-Cardiologist care in which PCPs and cardiologists share data via a secure CareLinker website to determine interventional approaches. The primary outcome is mean change in systolic blood pressure (SBP) over a 12-month period. Secondary outcomes are changes of diastolic blood pressure (DBP), HbA1C, blood lipids, and medication adherence measured by the eight-item Morisky Medication Adherence Scale MMAS.

Discussion: This study will determine whether a coordinated PCP-Cardiologist Telemedicine Model (PCTM) that incorporates the lasted telemedicine technologies will improve hypertension care. Success of the model would help streamline the present community healthcare processes and impact a greater number of uncontrolled hypertensive patients.

Connect with a study center

Shanghai Chest Hostpital
Shanghai, Shanghai 200030
China
Active - Recruiting

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