Hypertension home telemonitoring -: Current evidence and recommendations for future studies

Home telemonitoring is a patient-management approach that allows timely data transfer and immediate feedback. With the large number of people experiencing hypertension worldwide and the burden of this medical condition, home blood pressure (BP) telemonitoring has become popular given its potential for reducing cost and improving patient care. This study provides an overview on the current evidence and trends of hypertension telemonitoring, and presents recommendations for future studies in this area. A comprehensive literature search was conducted from 1966 to 2006 on Cochrane Library, ScienceDirect, PubMed, MEDLINE, EMBASE, CINAHL, and PsycINFO using the key words 'hypertension', 'blood pressure', 'telemonitoring', 'telecare', 'telemedicine', 'biotelemetry', 'telehealth', and 'telehomecare'. Fourteen studies involving telemonitoring experiments were found and included in this review, ten of which were conducted in Europe and the US. The studies present evidence on the positive impacts of telemonitoring on patients and their conditions (e.g. significant BP control, better medication adherence, changes in patients' lifestyle). However, the results of the studies should be considered with caution due to the limitations of study designs. Furthermore, little is known about the effects of telemonitoring on services utilization and only one study demonstrated a detailed cost-effectiveness analysis of this approach. This review presents preliminary evidence on the benefits of telemonitoring as a successful patient-management approach. However, at present, limited information exists that would substantiate its effects on the utilization of health services (e.g. office and emergency room visits, hospitalizations) and demonstrate its economic viability. Future studies should examine the effects of mediating variables and the mechanisms through which BP control is achieved. Further research should also incorporate designs that allow more control and investigate its effects over longer time periods with larger diversified samples of patients.