Accuracy of Telemedicine in Detecting Uncontrolled Hypertension and Its Impact on Patient Management

Abstract

This study was aimed at assessing the diagnostic accuracy of telemedicine among hypertensive patients. This was a cross-sectional analysis of patients attending a hypertension clinic over a year-long study. Patients were seen both by telemedicine and in-person on the same day with order of the encounters randomly determined. A telemedicine system, which utilized phone lines, was employed. For each type of encounter, whether telemedicine (TM) or in-person (IP), clinical data on blood pressure (BP) control as well as physician ordering patterns were collected. Receiver Operator Characteristic (ROC) curves were used to assess the validity of TM as compared to IP in the assessment of uncontrolled hypertension. Sixty-two patients participated resulting in 107-paired visits over the year-long study period. The mean age of the 62 participants was 67.1 ± 11.4 years; 56.6% were men. ROC curves for detecting elevated mean blood pressure provided an area under the curve (auc) of 0.87 (95% CI, 0.80-0.95). ROC curves for the detection of uncontrolled systolic hypertension provided an auc of 0.86 (95% CI, 0.78-0.93). Telemedicine-determined BP differed slightly, but statistically significant (p < 0.05), from IP assessments. Meanwhile, there was no difference in ordering diagnostic tests or therapeutics detectable between the two encounter types. Telemedicine proved to be a valid means for detecting uncontrolled BP among hypertensive patients.