Office of Research & Development |
  |
Talk to the Veterans Crisis Line now
An official website of the United States government
VA Research Currents archive
Posted July 16, 2013
(Summer 2013 VA Research Currents)
Pamela Gentry, RN, was one of the Durham VA Medical Center nurses who delivered telephone counseling to patients as part of the Hypertension Intervention Nurse Telemedicine Study. (Photo by Linnie Skidmore)
Veterans with hypertension and diabetes were less likely to develop retinal disease—a common diabetes complication—when they received special medication management through a VA study called the Hypertension Intervention Nurse Telemedicine Study.
The same improvement—a 50 percent reduction in risk—was seen when the medication management was combined with behavioral education, delivered by nurses to Veterans via telephone. The behavioral intervention by itself, however, was no more effective than usual care.
The medication management involved collaboration between doctors and nurses. They tracked blood pressure readings sent by the Veterans three times per week via telemedicine devices. Based on the readings and Veterans' individual medical profiles, the study team adjusted medication regimens per clinical guidelines and a flowchart-like decision-support system.
In the telephone behavioral intervention, nurses counseled the Veterans on sticking to their medication regimens and making healthy lifestyle choices.
The study involved 593 Veterans with high blood pressure, including 252 who also had diabetes. Previous analyses from the study reported modest improvements in blood pressure control in response to both interventions—medication management and behavioral education. Larger effects were seen among those Veterans with poor blood pressure control to begin with, and among African Americans, who made up about half the study population.
(JAMA Ophthalmology, online May 23, 2013)