Possibilities of telemedicine influence on the level of systolic blood pressure in patients with diabetes mellitus in combination with arterial hypertension

The article analyzes the possibility of the influence of telemedicine on the levels of systolic blood pressure in patients with type 2 diabetes mellitus in combination with arterial hypertension. The study involved 224 patients who were initially divided into 2 groups: group 1 (patients who refused to undergo structured training; n = 54) and group 2 (patients who underwent structured training; n = 170). Subsequently, the patients of group 2 were divided into two subgroups: group 2a, consisting of 109 patients who underwent structured training, but did not use feedback from the doctor every 2 weeks, carried out in the form of telemedicine; group 2b, consisting of 61 patients who underwent structured training and made contacts with a doctor every 2 weeks. In order to increase the effectiveness of training, family members of the patient living with him often also participated in the process. In some cases, group training was used (no more than 3 people in 1 group, taking into account age, psychological and intellectual compatibility). As a result of the study, it was found that in all three groups, the systolic blood pressure levels at the end of the study were lower than the baseline levels, and in all cases, the differences between the initial and final levels of this indicator were statistically significant. However, with the initial levels of systolic blood pressure not statistically significantly different from each other, the most optimal result was obtained in group 2b – 133.3 mm Hg. (95% CI 131.46; 135.14) and 2a – 133.7 mm Hg. (95% CI 132.25; 135.15). In group 2b, a more gradual decrease in systolic blood pressure was noted than in group 2a. In addition, there were also statistically significant differences in the incidence of systolic blood pressure < 130 mm Hg. at the end of the study between groups 1 and 2a (p < 0.0001) and the difference between the frequency of occurrence of systolic blood pressure < 130 mm Hg. at the end of the study between groups 1 and 2b (p < 0.001). According to the results obtained, it can be argued that structured learning made it possible to achieve a more effective reduction in the level of systolic blood pressure compared to unstructured, "sketchy" learning. The feedback system "patient-doctor" using telemedicine technologies, used to manage arterial hypertension in type 2 diabetes mellitus, made it possible to achieve a smoother decrease in systolic blood pressure levels, while maintaining the effectiveness of therapy.

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