ArticleJournal of general internal medicine2025
Telemedicine Use and Hypertension Control in an Urban Community Health Center Cohort.
Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundReal-time or synchronous telemedicine can be a valuable adjunctive strategy for chronic disease management, but few studies have assessed its impact on hypertension control among safety-net populations.
objectiveTo evaluate whether telemedicine is associated with blood pressure (BP) control.
designRetrospective cohort study. Mixed-effects logistic regression models clustered by the patient estimated associations between telemedicine and BP control after adjusting for patient factors and neighborhood context.
participantsPatients seeking care at an urban, multisite community health center with hypertension and ≥1 BP measurement between 2020 and 2022 (3663 patient-year observations across 2086 unique patients). MAIN MEASURES: The primary outcome was BP control defined as a binary variable. We used the Centers for Medicare & Medicaid Services' Controlling High Blood Pressure quality measure criteria of systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg in the most recent recording in the measurement year. KEY
resultsAmong the 2086 patients with hypertension in our sample, there were 1257 (60.3%) Latinx and 425 (20.4%) Black patients. Over 90% lived in a neighborhood of high deprivation as categorized by the social deprivation index. Telemedicine visits, compared to none, were not associated with blood pressure control (1-2 telemedicine visits aOR, 1.05 [95% CI, 0.86-1.28]; ≥3 telemedicine visits aOR, 0.86 [95% CI, 0.68-1.09]). One in-person visit per year, compared to 2-3, was associated with lower odds of BP control (aOR, 0.72 [95% CI, 0.55-0.94]). Black patients, compared to Latinx patients, were less likely of having BP control (aOR, 0.64 [95% CI, 0.48-0.87]).
conclusionsIn this community health center cohort of patients with hypertension, telemedicine did not compromise blood pressure control. Persistent racial disparities in blood pressure control underscore the need for equity-centered strategies for hypertension management in safety-net primary care settings.
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