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Journal of Telemedicine and Telecare

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J Telemed Telecare 2009;15:397-403
doi:10.1258/jtt.2009.090509
© 2009 Royal Society of Medicine Press

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RESEARCH

Original articles

The physician at a distance: the use of videoconferencing in the treatment of patients with hypertension

Mats Nilsson *, Ulf Rasmark {dagger}, Helena Nordgren {dagger}, Per Hallberg {ddagger}, Johan Skönevik {ddagger}, Göran Westman § and Olov Rolandsson § 


* Futurum - the Academy of Healthcare, Jönköping County Council, Jönköping; {dagger} Lövånger Primary Health Care Centre, Västerbotten County; {ddagger} Biomedical Engineering and Informatics, University Hospital of Umeå, Umeå; § Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden


Correspondence: Dr Olov Rolandsson, Family Medicine, By 9A, NUS, 901 85 Umeå, Sweden (Fax: +46 90 776 883; Email: olov.rolandsson{at}fammed.umu.se)


We evaluated the feasibility and quality of uncomplicated hypertension care based on telemedicine in a rural area of northern Sweden. The intervention subjects were 91 consecutive patients with primary hypertension. For comparison, 182 age- and sex-matched patients with hypertension were randomly selected from a similar health centre. The telemedicine equipment consisted of a video link between the physician and the patients, supported by a system for accessing medical data via the Internet. During a 21-month study period, telemedicine was used in 270 (91%) of the 297 consultations in the intervention group. All health personnel involved in the telemedicine treatment rated the method as feasible. Both systolic and diastolic blood pressure improved in the two groups during the study period. In the intervention group, a higher proportion had their blood pressure within treatment goals (systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg) both at baseline and at follow-up than in the comparison group. An adjusted multivariate model (adjustment for sex, age, time between visits, change in number of drugs between first and last visit, blood pressure at first visit) showed that the intervention group had a higher probability (OR 2.7, 95% CI 1.4–5.2) of reaching the target blood pressure levels than the reference group. Treatment of hypertension by means of telemedicine was quite feasible and at least as effective as face-to-face consultations with a physician.


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