Remote monitoring in health management of elderly patients with arterial hypertension

Aim. To evaluate the effectiveness of the MediSimo remote monitoring platform in the management of patients with arterial hypertension (AH) aged 60 years and older in outpatient practice. 
Materials and methods. A prospective study was conducted with the formation of a retrospective control group. The main group included 247 patients, of whom 213 completed 12 months of follow-up using remote monitoring. The control group consisted of 400 patients receiving standard care. Clinical and demographic characteristics, parameters of antihypertensive therapy, blood pressure (BP) levels, treatment adherence assessed by the Morisky–Green scale (MMAS-4), as well as the frequency of outpatient visits, hospitalizations and telemedicine consultations per patient per year were evaluated. 
Results. Baseline characteristics of the groups were comparable in terms of key demographic and clinical parameters. After 12 months, the remote monitoring group demonstrated a reduction in systolic BP by 7 mmHg (p < 0.05) and an increase in the proportion of patients with target BP < 130/80 mmHg from 33.3 % to 78.4 %, whereas no significant changes in BP were observed in the control group. Treatment adherence improved (MMAS‑4 median increased from 2 to 3 points; p < 0.05). Optimization of antihypertensive therapy was noted, including a decrease in the proportion of monotherapy and increased use of combination regimens and once-daily medications. The frequency of outpatient visits and hospitalizations decreased approximately twofold, while the number of telemedicine consultations increased 2.8-fold. The proportion of patients who underwent preventive medical examinations and achieved clinically significant weight loss also increased. 
Conclusion. Remote monitoring using the MediSimo platform in older patients with AH is associated with improved BP control, enhanced treatment adherence and more rational use of outpatient and inpatient resources through a reduction in face-to-face visits and hospitalizations alongside an increased share of telemedicine consultations.

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