the international council on medical & care compunetics


December, 2014

home monitoring

The case for home monitoring in hypertension

Padfield PL. BMC Medicine, 8(1)

Although the assessment of cardiovascular risk in individual patients takes into account a range of risk factors, the diagnosis and management of hypertension (high blood pressure) is largely determined by a single numerical value, albeit that often several readings are taken over time. Given the critical impact of a decision to embark on lifelong drug therapy the importance of ensuring that a blood pressure (BP) record is both accurate and representative is clear. However, there is good evidence that the variability of BP is such that even if measurement is of the highest quality it can be difficult to say with confidence whether a patient is above or below a treatment threshold.
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13 October 2010 | No Comments »
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Impact of blood pressure telemonitoring on hypertension outcomes: a literature review

AbuDagga A et al, Telemedicine and e-Health, 16(7)

We searched five databases (PubMed, CINAHL, PsycINFO, EMBASE, and ProQuest) from 1995 to September 2009 to collect evidence on the impact of blood pressure (BP) telemonitoring on BP control and other outcomes in telemonitoring studies targeting patients with hypertension as a primary diagnosis. Fifteen articles met our review criteria. We found that BP telemonitoring resulted in reduction of BP in all but two studies; systolic BP declined by 3.9 to 13.0 mm Hg and diastolic BP declined by 2.0 to 8.0 mm Hg across these studies. These magnitudes of effect are comparable to those observed in efficacy trials of some antihypertensive drugs.
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6 October 2010 | No Comments »
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A pilot study of nurse-led, home-based telecardiology for patients with chronic heart failure

Scalvini S et al, J Telemed Telecare, 10(2)

We assessed the feasibility of home-based telecardiology for patients with chronic heart failure (CHF). Seventy-four CHF patients were enrolled into a programme of telephone follow-up and single-lead electrocardiography (ECG) monitoring. The patients transmitted their ECG data by fixed telephone line to a receiving station, where a nurse was available for an interactive teleconsultation. Patients were followed up for a mean (SD) of 307 (108) days; 1467 calls were analysed (213 ad hoc consultations and 1254 scheduled consultations).
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8 August 2010 | No Comments »
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Two Self-management Interventions to Improve Hypertension Control: A Randomized Trial

Bosworth, Hayden B. et al, Ann Intern Med, 151(10)

Fewer than 40% of persons with hypertension in the United States have adequate blood pressure (BP) control.

To compare 2 self-management interventions for improving BP control among hypertensive patients.
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11 October 2009 | No Comments »
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Advanced Data Capture in the Assisted Medical Home: A Model for Distributed and Multimedia Technologies

Churchill, Richard et al, Journal of Medical Systems, Published online: 18 April 2009

Expanding the role of distributed health care, recent ONCHIT initiatives highlight the utilization of remote and home-based monitoring as a model for health care that is accessible, comprehensive and coordinated, delivered in the context of family and community. Extensible information technology in this context can be used to collect and store expanded data about patients and their environment, especially in assisted living and group home environments.
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23 April 2009 | No Comments »
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Evaluation of a Novel Ambulatory Device for Screening of Sleep Apnea

Tiihonen, Pekka et al, Telemedicine and e-Health, 15(3)

The standard for diagnosing obstructive sleep apnea (OSA) is the sleep laboratory polysomnography, which is technically demanding, labor-intensive, and time-consuming. This study evaluated the diagnostic and technical reliability of a novel ambulatory device recording breathing movements, nasal and oral air flow, position, snore, blood oxygen saturation, and heart rate. Ten simultaneous polygraphic recordings were compared in a sleep laboratory setting and a larger series of home recordings. Similar diagnostic sensitivity in detecting OSA was found with the ambulatory device. Apnea-hypopnea indices and oxygen desaturation indices were closely correlated (r = 0.996-0.997, p < 0.0001). The quality of 90.0% of home recordings was technically perfect and 96.0% of recordings were of diagnostically acceptable quality. The novel device was found clinically applicable, technically reliable, sensitive for the diagnostics of OSA, and suitable for telemedicine.
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22 April 2009 | No Comments »
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Measurement of physical quantities in upper-limb tele-rehabilitation

Rogante, Marco et al, J Telemed Telecare 2009;15

A total of 50 patients (affected by traumatic brain injury, stroke or multiple sclerosis) were treated for one month using a rehabilitation protocol. Rehabilitation could be monitored using a Portable Unit (PU) which could be installed in a patient’s home allowing the measurement of kinetic and kinematic variables during exercise.
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16 April 2009 | No Comments »
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Non-invasive monitoring of the activities of daily living of elderly people at home – a pilot study of the usage of domestic appliances

Franco, Georgina Corte et al, J Telemed Telecare, 14(5)

We conducted a feasibility study of a system for non-invasive monitoring of subjects at home. Electrical activity was recorded from room lights and from electrical domestic appliances; this was translated into the probability of physical activity or a particular Activity of Daily Living (ADL). Thirteen volunteer subjects were monitored for a period of 6.4 months (range 3-8).
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23 July 2008 | No Comments »
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Design, construction and evaluation of an ambulatory device for screening of sleep apnea

Tiihonen, Pekka, Medical & Biological Engineering & Computing, 47(1)

Obstructive sleep apnea syndrome (OSAS) is a major public health problem. The golden reference for diagnosing OSAS is the sleep-laboratory based polysomnography (PSG). However, screening of population for OSAS may be practical and cost efficient only through ambulatory home recordings. In this work we aimed to design, construct and evaluate a novel ambulatory device for these recordings.
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8 February 2008 | No Comments »
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