Mar. 31, 2008 When it comes to matters of the heart, many experts say that communication is the key to a healthy relationship. But a recent study out of Temple University’s School of Medicine finds that communication is the key to a healthy heart, as well.
Alfred Bove, professor emeritus of medicine at the School of Medicine and chief of cardiology at Temple University Hospital, along with researchers at Temple’s Telemedicine Research Center, recently finished a four-year study that examined the prevention of heart disease in at-risk, but otherwise healthy patients in rural and urban settings through frequent patient-doctor communications. The patients and doctors interacted via an internet-based health reporting system in conjunction with regular clinic visits.
Researchers found that adding the internet reporting system to traditional office visits allowed participants to communicate more frequently with their healthcare providers, and as a result, they were able to lower their risk of heart disease by improving blood pressure, blood lipid levels and cardiovascular disease risk score.
Bove believes that telemedicine’s use in populations that are generally underserved by the healthcare system can bridge what he calls the “medical divide” between treatment and outcomes for upper- and lower-income patients. Communications with a doctor between in-person visits encourages these patients to take a more proactive approach to their healthcare through self-monitoring and self-reporting.
Participants were randomly divided into a control group or a telemedicine group and received a device to measure blood pressure and a pedometer to measure daily steps, along with advice on exercising and its benefits in preventing heart disease. The telemedicine group also regularly transmitted their blood pressure, weight and pedometer data to cardiologists, and received feedback and educational information via the internet.
Participants of both groups had significant reductions in blood pressure, lipids and cardiovascular disease risk scores, and were able to walk farther distances. While researchers expected an improvement among the telemedicine group, based on previous research, they were surprised at the success the control group had, due in large part to clinic nurses, who Bove said “did an excellent job in communicating to patients the importance of preventing cardiovascular disease.”
“Communication between a patient and their primary care provider works for prevention of cardiovascular disease, whether it’s in the office, or over the internet,” said Bove, adding that the telemedicine approach does have some advantages to traditional patient visits.
“With rising healthcare costs, a telemedicine system can encourage communication between patients and their doctors with less cost and time commitment than frequent doctor visits,” he said.
While both urban and rural groups showed marked improvement in their heart health, those in the rural location were found to do slightly better overall than the urban group. Study co-author Carol Homko, R.N., Ph.D., an adjunct faculty member at the School of Medicine, noted that this was most likely because at baseline, those participants had a better understanding and more knowledge of cardiovascular disease than did their urban counterparts.
Several additional research projects regarding telemedicine are currently ongoing at Temple University, including its use in monitoring hypertension, gestational diabetes, head trauma, and gastrointestinal and pulmonary health. Bove and his team are hoping to next study telemedicine’s use in controlling diabetes, given the success that diabetic participants had while enrolled in this study.
“There are myriad different uses for this system, and we’ve been very fortunate to be at the forefront,” said Bove. “This is an excellent way to encourage patients to communicate directly with their primary care physicians and become empowered to ask questions and become proactive in their healthcare.”
These findings will be presented at the American College of Cardiology’s annual meeting on March 30. Other authors on this study are William P. Santamore, Ph.D., and Mohamed Kashem, M.D., of Temple University Hospital; and Timothy McConnell, Ph.D., Gail Shirk, R.N., Robert Cross, M.D., and Francis Menapace, M.D., of Geisinger Medical Center in Danville, Pa. Bove and Santamore have a consultant relationship with Insight Telehealth, LLC, a partner on this study. Funding was provided by a grant from the Pennsylvania Department of Health.
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