Background: Hypertension is a major risk factor for cardiovascular disease, and its control rate has remained low\nworldwide. Studies have found that telemonitoring blood pressure (BP) helped control hypertension in randomized\ncontrolled trials. However, little is known about its effect in a structured primary care model in which primary care\nphysicians (PCPs) are partnering with cardiology specialists in electronic healthcare data sharing and medical\ninterventions. This study aims to identify the effects of a coordinated PCP-cardiologist model that applies telemedicine\ntools to facilitate community hypertension control in China.\nMethods/design: Patients with hypertension receiving care at four community healthcare centers that are academically\naffiliated to Shanghai Chest Hospital, Shanghai JiaoTong University are eligible if they have had uncontrolled BP in the\nprevious 3 months and access to mobile Internet. Study subjects are randomly assigned to three interventional groups:\n(1) usual care; (2) home-based BP telemonitor with embedded Global System for Mobile Communications (GSM)\nmodule and unlimited data plan, an app to access personal healthcare record and receive personalized lifestyle coaching\ncontents, and proficiency training of their use; or (3) this plus coordinated PCP-cardiologist care in which PCPs and\ncardiologists share data via a secure CareLinker website to determine interventional approaches. The primary\noutcome is mean change in systolic blood pressure over a 12-month period. Secondary outcomes are changes of\ndiastolic blood pressure, HbA1C, blood lipids, and medication adherence measured by the eight-item Morisky\nMedication Adherence Scale.\nDiscussion: This study will determine whether a coordinated PCP-Cardiologist Telemedicine Model that\nincorporates the latest telemedicine technologies will improve hypertension care. Success of the model would\nhelp streamline the present community healthcare processes and impact a greater number of patients with\nuncontrolled hypertension.
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