Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review.
Hypertension remains the leading cause of cardiovascular disease worldwide and disproportionately impacts patients living in low- and middle-income countries (LMICs). Telemedicine offers a potential solution for improving access to health care for vulnerable patients in LMICs.<h4>Objectives<...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0254222&type=printable |
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| author | Michael Hoffer-Hawlik Andrew Moran Lillian Zerihun John Usseglio Jennifer Cohn Reena Gupta |
| author_facet | Michael Hoffer-Hawlik Andrew Moran Lillian Zerihun John Usseglio Jennifer Cohn Reena Gupta |
| author_sort | Michael Hoffer-Hawlik |
| collection | DOAJ |
| description | Hypertension remains the leading cause of cardiovascular disease worldwide and disproportionately impacts patients living in low- and middle-income countries (LMICs). Telemedicine offers a potential solution for improving access to health care for vulnerable patients in LMICs.<h4>Objectives</h4>The purpose of this scoping review was to summarize the evidence for telemedicine interventions for blood pressure management in LMICs and assess the relationships between the telemedicine intervention characteristics and clinical outcomes.<h4>Design</h4>Published studies were identified from the following databases (from their inception to May 2020): PubMed, Scopus, and Embase. Search terms related to "Low and Middle Income Countries," "Telemedicine," and "Hypertension" were used, and clinical outcomes were extracted from the screened articles.<h4>Results</h4>Our search resulted in 530 unique articles, and 14 studies were included in this review. Five studies assessed telemedicine interventions for patient-provider behavioral counseling, four assessed patient-provider medical management, and five assessed provider-provider consultation technologies. Out of fourteen individual studies, eleven demonstrated a significant improvement in systolic or diastolic blood pressure in the intervention group. Of the eight studies that reported difference-in-differences changes in systolic blood pressure, between-arm differences ranged from 13.2 mmHg to 0.4 mmHg.<h4>Conclusions</h4>The majority of the studies in this review demonstrated a significant reduction in blood pressure with use of the telemedicine intervention, though the magnitude of benefit was not consistently large. Limitations of the studies included small sample sizes, short duration, and intervention heterogeneity. Current evidence suggests that telemedicine may provide a promising approach to increase access to care and improve outcomes for hypertension in LMICs, especially during events that limit access to in-person care, such as the COVID-19 pandemic. However, high-quality clinical trials of sufficient size and duration are needed to establish the impact and role of telemedicine in hypertension care. The protocol for this review was not registered. |
| format | Article |
| id | doaj-art-0a631d4fa1fa4273b1b0a8ea84d2a962 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-0a631d4fa1fa4273b1b0a8ea84d2a9622025-02-05T05:32:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01167e025422210.1371/journal.pone.0254222Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review.Michael Hoffer-HawlikAndrew MoranLillian ZerihunJohn UsseglioJennifer CohnReena GuptaHypertension remains the leading cause of cardiovascular disease worldwide and disproportionately impacts patients living in low- and middle-income countries (LMICs). Telemedicine offers a potential solution for improving access to health care for vulnerable patients in LMICs.<h4>Objectives</h4>The purpose of this scoping review was to summarize the evidence for telemedicine interventions for blood pressure management in LMICs and assess the relationships between the telemedicine intervention characteristics and clinical outcomes.<h4>Design</h4>Published studies were identified from the following databases (from their inception to May 2020): PubMed, Scopus, and Embase. Search terms related to "Low and Middle Income Countries," "Telemedicine," and "Hypertension" were used, and clinical outcomes were extracted from the screened articles.<h4>Results</h4>Our search resulted in 530 unique articles, and 14 studies were included in this review. Five studies assessed telemedicine interventions for patient-provider behavioral counseling, four assessed patient-provider medical management, and five assessed provider-provider consultation technologies. Out of fourteen individual studies, eleven demonstrated a significant improvement in systolic or diastolic blood pressure in the intervention group. Of the eight studies that reported difference-in-differences changes in systolic blood pressure, between-arm differences ranged from 13.2 mmHg to 0.4 mmHg.<h4>Conclusions</h4>The majority of the studies in this review demonstrated a significant reduction in blood pressure with use of the telemedicine intervention, though the magnitude of benefit was not consistently large. Limitations of the studies included small sample sizes, short duration, and intervention heterogeneity. Current evidence suggests that telemedicine may provide a promising approach to increase access to care and improve outcomes for hypertension in LMICs, especially during events that limit access to in-person care, such as the COVID-19 pandemic. However, high-quality clinical trials of sufficient size and duration are needed to establish the impact and role of telemedicine in hypertension care. The protocol for this review was not registered.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0254222&type=printable |
| spellingShingle | Michael Hoffer-Hawlik Andrew Moran Lillian Zerihun John Usseglio Jennifer Cohn Reena Gupta Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. PLoS ONE |
| title | Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. |
| title_full | Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. |
| title_fullStr | Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. |
| title_full_unstemmed | Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. |
| title_short | Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. |
| title_sort | telemedicine interventions for hypertension management in low and middle income countries a scoping review |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0254222&type=printable |
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