{"title":"评估远程医疗干预对降低收缩压和舒张压的影响:系统回顾和荟萃分析。","authors":"Khadijeh Moulaei, Peyvand Parhizkar Roudsari, Adel Shahrokhi Sardoo, Mobina Hosseini, Mehrdad Anabestani, Reza Moulaei, Babak Sabet, Mohammad Reza Afrash","doi":"10.1177/1357633X241291222","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. Managing it is particularly challenging in areas with limited healthcare access and for patients who cannot attend regular in-person visits. Telemedicine interventions offer a promising solution by improving patient adherence and facilitating timely treatment adjustments. This study aims to systematically evaluate the impact of these telemedicine interventions on reducing systolic and diastolic blood pressure.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. Two independent reviewers screened and selected eligible articles, extracting key data using a standardized form. The quality of the included studies was assessed with the Mixed Methods Appraisal Tool (MMAT). A random effects model was used to combine the results, with treatment effects measured using standardized mean differences (Hedges's g). Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0.</p><p><strong>Results: </strong>Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = -0.22 (95% CI: -0.30 to -0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = -0.27, 95% CI: -0.39 to -0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = -0.17, 95% CI: -0.26 to -0.07; p-value < 0.001), though both reductions were clinically relevant.</p><p><strong>Conclusion: </strong>This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. These findings highlight the potential of telemedicine as an effective strategy for enhancing patient outcomes in hypertension care.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X241291222"},"PeriodicalIF":3.5000,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing the impact of telemedicine interventions on systolic and diastolic blood pressure reduction: A systematic review and meta-analysis.\",\"authors\":\"Khadijeh Moulaei, Peyvand Parhizkar Roudsari, Adel Shahrokhi Sardoo, Mobina Hosseini, Mehrdad Anabestani, Reza Moulaei, Babak Sabet, Mohammad Reza Afrash\",\"doi\":\"10.1177/1357633X241291222\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. 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Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0.</p><p><strong>Results: </strong>Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = -0.22 (95% CI: -0.30 to -0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = -0.27, 95% CI: -0.39 to -0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = -0.17, 95% CI: -0.26 to -0.07; p-value < 0.001), though both reductions were clinically relevant.</p><p><strong>Conclusion: </strong>This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. 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引用次数: 0
摘要
背景:以高血压为特征的高血压是心血管疾病、中风和心脏病发作的重要危险因素。在医疗条件有限的地区,以及对于无法定期到医院就诊的患者来说,管理高血压尤其具有挑战性。远程医疗干预通过提高患者的依从性和促进及时调整治疗方案,提供了一种很有前景的解决方案。本研究旨在系统评估这些远程医疗干预措施对降低收缩压和舒张压的影响:方法:对 PubMed、Scopus 和 Web of Science 进行了全面搜索,以确定相关研究。两位独立审稿人筛选出符合条件的文章,并使用标准表格提取关键数据。采用混合方法评估工具(MMAT)对纳入研究的质量进行评估。采用随机效应模型合并研究结果,并使用标准化平均差(Hedges's g)衡量治疗效果。通过统计检验(包括 Q 检验和 I² 统计量)评估研究结果的一致性,以评估异质性。数据分析使用 Stata 统计软件 17.0 版进行:在检索到的 2700 篇文章中,有 35 项研究被选入分析。使用随机效应模型,总体效应大小为 Hedges's g = -0.22(95% CI:-0.30 至 -0.15;P 值 结论:该研究表明,远程医疗在提高医疗质量方面发挥着重要作用:本研究表明,远程医疗干预能显著降低收缩压和舒张压,对收缩压的影响更为明显。总体效应大小表明,在高血压管理方面取得了微小但有意义的改善。这些研究结果凸显了远程医疗作为提高高血压患者治疗效果的有效策略的潜力。
Assessing the impact of telemedicine interventions on systolic and diastolic blood pressure reduction: A systematic review and meta-analysis.
Background: Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. Managing it is particularly challenging in areas with limited healthcare access and for patients who cannot attend regular in-person visits. Telemedicine interventions offer a promising solution by improving patient adherence and facilitating timely treatment adjustments. This study aims to systematically evaluate the impact of these telemedicine interventions on reducing systolic and diastolic blood pressure.
Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. Two independent reviewers screened and selected eligible articles, extracting key data using a standardized form. The quality of the included studies was assessed with the Mixed Methods Appraisal Tool (MMAT). A random effects model was used to combine the results, with treatment effects measured using standardized mean differences (Hedges's g). Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0.
Results: Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = -0.22 (95% CI: -0.30 to -0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = -0.27, 95% CI: -0.39 to -0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = -0.17, 95% CI: -0.26 to -0.07; p-value < 0.001), though both reductions were clinically relevant.
Conclusion: This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. These findings highlight the potential of telemedicine as an effective strategy for enhancing patient outcomes in hypertension care.
期刊介绍:
Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.