Impact of the environment on human migration in Eurasia

Abstract

Objectives: To evaluate effectiveness of an interventional strategy (disease management program (DMP)) supported by a telemedicine platform in patients with mild/moderate hypertension. Methods: Quasi-experimental design, paired data with control group (1:2, patients were matched by age and gender). Study population and follow-up period: Patients from 6 primary care centers in Badalona (Barcelona, Spain) were followed-up during 2011 and 2012. Study groups: Intervention group (telemedicine program) and control group (usual clinical practice). The intervention consisted on establishing a permanent channel of interaction with the patient (telemedicine platform) and providing the patient with educational materials, clinical monitoring, SMS, phone calls, etc. Main measures: Demographic co-morbidity, anthropometric and biochemical parameters, adherence to treatment blood pressure control (BP: 140/90 mmHg), associated health care management costs and satisfaction surveys to professionals and patients. Statistical significance:p< 0.05. Results: A total of 750 patients were included (intervention group n= 250, control group n= 500). Mean age was of 64.2 years old 52.1% of patients were women. The control group was selected to show an optimal comparability in terms of demographic and morbidity measures between the two groups. The intervention group showed better compliance (87.9% vs. 71.4%, p= 0.001). BP control was 52.5 vs. 53.1% (p= NS) initially and 63.2% vs. 55.6% at the end of the study (p< 0.001) for the intervention group vs. control, respectively. The follow-up average cost per patient and year was 377.9 vs. 442.4, p< 0.001 (reduction in intervention group: 66 ). 82% of health care professionals and 91% of patients were satisfied with the DMP. Conclusions: The DMP has improved adherence to treatment and BP control and has reduced health care management costs. If the study results were extrapolated to the overall population of Badalona, a potential saving of 1.7 million per year would be achieved.