# Thuisbloeddruk-geleide farmacotherapie via telezorg: meta-analyse van VS-trials

*geplaatst 2024-03-01 · Hypertensie · Hypertension (Dallas, Tex. : 1979) · doi 10.1161/HYPERTENSIONAHA.123.22109 · https://hartvaat.nl/2024/03/01/thuisbloeddruk-geleide-farmacotherapie-via-telezorg-meta-analyse-van-vs-trials/*

Meta-analyse van Amerikaanse telezorgtrials bevestigde dat thuisbloeddruk-geleide farmacotherapie de bloeddrukcontrole significant verbetert. Telezorg is een effectief model voor hypertensiemanagement in de eerstelijn.

## English: Self-Measured Blood Pressure-Guided Pharmacotherapy: A Systematic Review and Meta-Analysis of United States-Based Telemedicine Trials.

This meta-analysis of US-based telehealth trials confirmed that self-measured blood pressure-guided pharmacotherapy significantly improves blood pressure control compared with usual care, supporting the implementation of telemedicine hypertension management.

## Abstract (original, from the publication)

BACKGROUND: The optimal approach to implementing telemedicine hypertension management in the United States is unknown. METHODS: We examined telemedicine hypertension management versus the effect of usual clinic-based care on blood pressure (BP) and patient/clinician-related heterogeneity in a systematic review/meta-analysis. We searched United States-based randomized trials from Medline, Embase, CENTRAL, CINAHL, PsycINFO, Compendex, Web of Science Core Collection, Scopus, and 2 trial registries. We used trial-level differences in BP and its control rate at ≥6 months using random-effects models. We examined heterogeneity in univariable metaregression and in prespecified subgroups (clinicians leading pharmacotherapy [physician/nonphysician], self-management support [pharmacist/nurse], White versus non-White patient predominant trials [>50% patients/trial], diabetes predominant trials [≥25% patients/trial], and White patient predominant but not diabetes predominant trials versus both non-White and diabetes patient predominant trials]. RESULTS: Thirteen, 11, and 7 trials were eligible for systolic and diastolic BP difference and BP control, respectively. Differences in systolic and diastolic BP and BP control rate were -7.3 mm Hg (95% CI, -9.4 to -5.2), -2.7 mm Hg (-4.0 to -1.5), and 10.1% (0.4%-19.9%), respectively, favoring telemedicine. Greater BP reduction occurred in trials where nonphysicians led pharmacotherapy, pharmacists provided self-management support, White patient predominant trials, and White patient predominant but not diabetes predominant trials, with no difference by diabetes predominant trials. CONCLUSIONS: Telemedicine hypertension management is more effective than clinic-based care in the United States, particularly when nonphysicians lead pharmacotherapy and pharmacists provide self-management support. Non-White patient predominant trials achieved less BP reduction. Equity-conscious, locally informed adaptation of telemedicine interventions is needed before wider implementation.

Auteurs: Sameer Acharya, Gagan Neupane, Austin Seals, Madhav Kc, Dean Giustini, Sharan Sharma, Yhenneko J Taylor, Deepak Palakshappa, Jeff D Williamson, Justin B Moore, Hayden B Bosworth, Yashashwi Pokharel

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Bron: Hypertension (Dallas, Tex. : 1979), https://doi.org/10.1161/HYPERTENSIONAHA.123.22109. Bijgewerkt 2026-07-03T18:39:08Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.