Blood Pressure Control in a Hypertension Telemedicine Intervention: Does Distance to Primary Care Matter?
Article first published online: 23 JUL 2013
©2013 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 15, Issue 10, pages 723–730, October 2013
How to Cite
J Clin Hypertens (Greenwich). 2013;15:723–730. ©2013 Wiley Periodicals, Inc.
- Issue published online: 1 OCT 2013
- Article first published online: 23 JUL 2013
- Manuscript Accepted: 22 JUN 2013
- Manuscript Revised: 13 JUN 2013
- Manuscript Received: 7 MAY 2013
- Office of Academic Affairs
- VA National Quality Scholars Fellowship
- VA Health Services Research and Development career scientist award. Grant Numbers: IIR 04-426, 08-027
Although telemedicine may help overcome geographic access barriers, it is unknown whether rural patients receive greater benefits. In a secondary analysis of 503 veterans participating in a hypertension telemedicine study, the authors hypothesized that patients with greater travel distances would have greater improvements in 18-month systolic blood pressure (SBP). Patients were categorized by telemedicine exposure and travel distance to primary care, derived from zip codes. Comparisons were (1) usual care (UC), distance <30 miles (reference); (2) UC, distance ≥30 miles; (3) telemedicine, distance <30 miles; (4) telemedicine, distance ≥30 miles. Compared with patients receiving UC, distance <30 miles (intercept=127.7), no difference in 18-month SBP was observed in patients receiving UC, distance ≥30 miles (0.13 mm Hg, 95% confidence interval [−6.6 to 6.8]); telemedicine, distance <30 miles (−1.1 mm Hg [−7.3 to 5.2]); telemedicine, distance ≥30 miles (−0.80 mm Hg [−6.6 to 5.1]). Although telemedicine may help overcome geographic access barriers, additional studies are needed to identify patients most likely to benefit.