Virtual hypertension visits offer convenience for clinicians, without compromising care

Virtual primary care visits for hypertension follow-ups are just as effective as in-person visits to maintain blood pressure control, according to a study published May 23 in the Journal of General Internal Medicine.

“Our central finding was that you can use online, non-simultaneous communication to manage a chronic medical condition without office visits that can be inconvenient for patients and add to demands placed on busy primary care practices,” said co-author Ronald Dixon, MD, of the Massachusetts General Hospital (MGH) in Boston, in a statement. “It also supports scaling this concept to other chronic diseases with the addition of devices allowing collection of needed patient information.” 

Hypertension, according to the researchers, accounts for 39 million office visits annually in the U.S., but there is little research into whether traditional visits are the best method for patient care.

The MGH researchers sought to compare blood pressure control in patients who received virtual visits with those who received usual care.

The study cohort included 893 patients from MGH who had an initial office clinical visit and all subsequent visits were virtual visits. The study group also included 893 patients from Brigham and Women’s Hospital (BWH) who had similar demographics, chronic conditions and cardiovascular risk factors.

The virtual visits platform allowed patients to enter up to five blood pressure readings taken since their last in-office or virtual visit. They could also report whether they were taking their medications as directed or if they were experiencing side effects. They could also ask questions about their treatment to their primary care physician.

The primary care physicians reviewed the data entered to make adjustments to treatment and to recommend repeat virtual visits, follow-up phone calls or in-office visits. The physician determined whether they wanted to offer virtual visits on a case-by-case basis.

Patients in both groups showed similar improvements in blood pressure control. The virtual care group had an average of 0.8 fewer follow-up visits, compared to the in-office group. There was no significant difference in systolic blood pressure, specialist visits, emergency department visits or inpatient admissions between both groups.

“The use of virtual visits to reduce in-person office utilization without negative effects on blood pressure control or the need for other services could significantly expand access for patients of busy primary care practices,” said co-author David Michael Levine, MD, of Brigham and Women’s Hospital in Boston, in the same statement. “Many groups, especially insurance companies, have been skeptical of virtual care because they believe it may increase the use of health care services, but our findings show that a virtual visit can substitute for, rather than add to, an in-person visit, decreasing overall health care utilization.”