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The Paradigm of Antihypertensive Therapy along with Telemedicine Randomized (POATRAND) trial was designed and performed as a prospective, randomized, open-label, 2-arm study of patients with uncontrolled, uncomplicated hypertension to test the effectiveness and safety of BP telemonitoring as well as hypertension telemedicine. In this study, we attempted to demonstrate the advantages of telemedicine over traditional care in the management of hypertension. However, clinical evidence concerning the efficacy and safety of telemedicine remains scarce. We developed an integrated web-based telemedicine platform to manage appointments, medical care, and payment without patients visiting a clinic.

In Japan, telemedicine without face-to-face communication has been permitted since early 2015. Adjusting antihypertensive medication based on self-measured home BP (HBP) for long periods is feasible, and HBP self-monitoring with self-titration of antihypertensive medication in accordance with an individualized predetermined protocol has been reported to result in better BP control than that with usual care (UC). Self-measurement of home BP (SMBP) helps improve adherence to treatment and aids in BP control. Technical difficulty and anxiety associated with telemedicine hence need to be managed sufficiently.ДЄchieving target BP levels in the treatment of hypertension requires patientsвЂ™ adherence to and persistence in taking their medication. This approach may also result in higher satisfaction among patients by allowing better use of their time rather than having them spend much of it waiting at clinics or hospitals. Telemedicine using internet-based communication may lower the hurdle for starting and adhering to hypertension treatment, eventually leading to the prevention of cardiovascular disease. Among the reasons why individuals do not take action to control their hypertension, the burden of time takes precedence for discontinuation or noninitiation of antihypertensive treatment. This phenomenon, termed the вЂњhypertension paradox,вЂќ must be resolved to improve public health. Nevertheless, in Japan, only 12 million of 43 million individuals with hypertension receive treatment and have their BP controlled. Trial Registration: UMIN-CTR UMIN000025372 JMIR Cardio 2021 5(2):e27347 doi:10.2196/27347 KeywordsДЄntihypertensive therapy has advanced over the years to enable lowering of blood pressure (BP) in most patients with hypertension if they receive proper treatment. The rate of SBP control (135 mmHg) was better in the telemedicine group (85.3% vs 70.0% P=.01), and significant adverse events were not observed.Д¬onclusions: We present evidence suggesting that antihypertensive therapy via home BP telemonitoring and web-based video visits achieve better BP control than conventional care and is a safe treatment alternative that warrants further investigation. SBP in the telemedicine group was 3.4 mmHg lower in the morning and 5.8 mmHg lower in the evening. Baseline BP was similar between the groups, but the weekly average SBP at the end of the 1-year study period was significantly lower in the telemedicine group (125, SD 9 mmHg vs 131, SD 12 mmHg, respectively P=.02). Results: Initial screening was completed by 99 patients, 54% of whom had untreated hypertension.

The UC group used the same BP monitoring device but was managed using self-recorded BP readings, which included their diary entries and office BP taken in a community practice setting. The telemedicine group used a 3G networkвЂ“attached home blood pressure (BP) monitoring device, consulted hypertension specialists from an academic hospital through web-based video visits, and received prescription medication by mail for 1 year.

They were then screened, stratified by office systolic blood pressure (SBP), and randomized into two groups: usual care (UC) and telemedicine. Methods: Patients with uncomplicated hypertension were recruited through web advertising between November 2015 and February 2017. Objective: This study examined the efficacy and safety of telemedicine for the management of hypertension in Japan. Telemedicine may help patients adhere to treatment by offering convenience. General Incorporated Association TelemedEASEД«ackground: The burden of time is often the primary reason why patients discontinue their treatment. JMIR Bioinformatics and Biotechnology 12 articles.JMIR Biomedical Engineering 58 articles.JMIR Perioperative Medicine 61 articles.Journal of Participatory Medicine 68 articles.JMIR Rehabilitation and Assistive Technologies 164 articles.JMIR Pediatrics and Parenting 221 articles.Interactive Journal of Medical Research 236 articles.JMIR Public Health and Surveillance 915 articles.Journal of Medical Internet Research 6701 articles.

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