Optimización del control de la presión arterial mediante telemedicina en atención primaria en España (Iniciativa Óptima): resultados de un estudio Delphi
- Carmen Sánchez-Peinador
- Joan Torras-Borrell
- María José Castillo Moraga
- María Isabel Egocheaga-Cabello
- Xiana Rodríguez-Villalón
- Miguel Turégano-Yedro
- Javier Gamarra-Ortiz
- Manuel Domínguez Sardiña
- Vicente Pallarés-Carratalá
ISSN: 0214-8986
Ano de publicación: 2022
Volume: 11
Número: 4
Tipo: Artigo
Outras publicacións en: Medicina general
Resumo
Aim. Members of the working groups on hypertension or cardiovascular disease of the Spanish Societies of Primary Care Physicians (PCPs) [SEMERGEN], Family and Community Medicine [semFYC] and General and Family Physicians [SEMG], conducted a Delphi study to validate with a panel of PCPs with expertise in hypertension several recommendations to optimize teleconsultation in hypertensive patients. Materials and methods. Delphi study based on an online questionnaire with 59 recommendations based on the available evidence and the clinical experience of the authors. Results. 118 PCPs participated in two rounds of the questionnaire (98.3% of the invited physicians), reaching consensus in 53/62 statements (85%). The PC team must proactively select the hypertensive patients suitable for telematic consultation and contact them to set up an appointment. Telematic consultation must begin explaining the reason and aims pursued, continuing with anamnesis, which must explore signs and symptoms of disease worsening, current treatments and level of adherence. In patients with a self-measured of blood pressure (SMBP) ≤ 135 / 85 mmHg, it is recommended to schedule a new telematic appointment in 3-6 months. On the contrary, asymptomatic patients with a SMBP ≥ 135 / 85 mmHg should undergo ambulatory BP monitoring, treatment modification or, in case of warning signs or symptoms, referral to a face-to-face visit or to emergency department. Conclusions. Teleconsultation can complement face-to-face consultation, constituting an additional tool for the appropriate follow-up of hypertensive patients.