Blood pressure telemonitoring and telemedicine for hypertension management—positions, expectations and feasibility of Latin–American practitioners. SURVEY carried out by several cardiology and hypertension societies of the Americas

Figures & data

Table 1. Baseline characteristics of the sample.

Variable	Total	Low-moderate telemonitoring probable	High telemonitoring probable
	n = 1753	n = 858	n = 821
Mean age (years ± SD)	50.8 ± 12.2	52 ± 13.6	49.5 ± 12.6
Male gender (n %)	1084–62.4	530–61.6	554–63.2
>10 years clinical practice (n %)	1453–83.2	720–84.1	733–83.6
>100 consults/month (n %)	992–58.6	481–57.3	511–59,8
Private practice (n %)	1010–37.4	514–38.8	496–36
Public Hospital setting (n %)	744–27.5	379–28.6	399–29
Practice city > 500,000 inhabitants (n %)	1135–65.7	518–60,7	616–70.5
Member of a working team (n %)	1420–81.6	664–77.2	756–85.8
Specialty (n %)
Cardiology	714–40.7	356–41.5	358–43.6
Internal medicine	245–14	116–13.5	129–15.7
General practitioner	197–11.2	108–12.6	89–10.8
Other	523–29.8	278–32.4	245–29.9
Active member scientific society (n %)	1275–73.4	595–69.3	680–77.5
Receive scientific journals (n %)	1406–82.5	704–81.9	732–83,1
Read at least 1 paper in the last 30 days (n %)	1567–90.1	755–87.9	812–92.1
Internet access (n %)	1703–98	838–97.6	865–98.5
Hardware availability (n %)	1680–90.5	810–94.1	870–98.9
Platforms knowledge (n %)	1407–81	157–88.1	600–74

1–5 means low; 6–8 means intermediate; 9–10 equals to high.

Table 2. Telemonitoring experience and attitudes.

Variable	Total	Low-moderate telemonitoring probable	High Telemonitoring probable
	n = 1753	n = 858	n = 821
Currently conducting telemonitoring (n %)	759–43.6	259–30.1	500–56.2
Considers herself/himself very apt to conduct telemonitoring (n %)	1140–65.7	395–29,1	745–84,8
High telemonitoring experience (n %)	584–33.7	117–13.6	467–53.2
Need telemonitoring training (n %)	1070–62	595–69.5	475–54.5
Considers telemonitoring highly important as consultation complement (n %)	882–50,9	232–27	653–74,4
Convinced telemonitoring is highly valuable to improve compliance (n %)	1114–64.1	385–44,6	729–83,3
Thinks that patients will highly prefer telemonitoring to face-to-face consultation (n %)	188–10.8	50–5,7	140–16
Consider confidentiality security is highly important in telemonitoring (n %)	1186–68.5	496–57.7	690–79,1
Do not know if healthcare financiers pay telemonitoring (n %)	753–43.1	402–48.6	331–37.7
Do not know if there is country legislation about telemonitoring (n %)	882–50.6	499–57.9	388–43.8
Consider to request informed consent (n %)	1537–88.6	763–88.6	774–88.5

1–5 means low; 6–8 means intermediate; 9–10 equals to high.

Table 3. Bivariate analysis showing association with high probability on telemonitoring.

Variable	OR	95% CI	p Value
Age in years compared to > 60
40 to 60	1.26	0.99–1.59	0.055
<40	1.39	1.05–1.84	0.02
Gender	1.06	0.87–1.29	0.56
Years of clinical practice compared to > 30
15 to 30	1.18	0.93–1.48	0.17
<15	1.30	1.01–1.70	0.04
Country residence compared to others
Mexico	1.44	1.12–1.87	0.005
Argentina	1.04	0.79–1.36	0.79
Colombia	1.57	1.16–2.12	0.004
Brazil	1.27	0.91–1.77	0.17
N consultations per month compared to <100
100 to 299	1.04	0.83–1.30	0.75
≥ 300	0.96	0.74–1.24	0.76
Specialty compared to others
Cardiology	1.13	0.91–1.42	0.27
General practitioner	0.93	0.67–1.28	0.65
Internal medicine	1.25	0.93–1.69	0.14
Type of work compared to lonely
Multidisciplinar team	1.82	1.42–2.35	<0.001
Specialty team	1.61	1.15–2.26	0.005
Working city compared to <100.000 inhabitants	1.66	1.27–2.17	<0.001
Academic activities	1.53	1.23–1.89	<0.001
Receiving journals compared to not receiving
Yes online	0.99	0.76–1.28	0.92
Yes print	1.31	0.71–2.42	0.39
Yes both	1.29	0.95–1.76	0.11
Read scientific manuscript in last 30 days	1.61	1.17–2.22	0.003
Knowledge telemonitoring platform	2.62	2.03–3.39	<0.001
Availability telemonitoring hardware	5.52	2.78–10.9	<0.001
Internet availability	1.70	0.84–3.38	0.15
Willingness to request specialized ‘call center’ support	1.06	0.87–1.30	0.57
Judgment positive relevance of telemonitoring on own-practice compared to 1–5 out of 10
6 to 8 out of 10	4.45	3.33–5.96	<0.001
9 to 10 out of 10	20.6	14.7–28.8	<0.001
How helpful could be telemonitoring to facilitate adherence to face-to-face recommendations compared to 1 to 5 out of 10
6 to 8 out of 10	4.91	3.40–7.10	<0.001
9 to 10 out of 10	17.5	12.1–25.5	<0.001
How many recommendations can be done by telemonitoring compared to 1 to 5 out of 10
6 to 8 out of 10	3.29	2.57–4.22	<0.001
9 to 10 out of 10	6.93	5.21–9.21	<0.001
Better way to connect to patients in telemedicine compared to phone-calls
hospital platform	1.01	0.72–1.42	0.98
professional platform	1.59	1.27–2.00	<0.001
videoconference	1.11	0.86–1.43	0.44
Paid telemonitoring by insurance companies in your country compared to ‘no’
yes	1.57	1.14–2.16	0.006
unknown	0.80	0.61–1.06	0.12
some of them	1.26	0.92–1.72	0.15
Telemedicine laws available in your country compared to ‘no’
yes	1.48	1.13–1.94	0.005
unknown	0.69	0.55–0.87	0.002
Payers accept electronic prescription in your country compared to ‘no’
yes	1.28	0.95–1.71	0.10
unknown	0.78	0.58–1.06	0.11
Informed consent request	0.99	0.74–1.34	0.97
Expectations about patients telemedicine preferences compared to 1 to 5 out of 10
6 to 8 out of 10	3.66	2.88–4.64	<0.001
9 to 10 out of 10	4.25	2.50–7.23	<0.001
Relevance of confidentiality compared to 1 to 5 out of 10
6 to 8 out of 10	3.36	2.43–4.65	<0.001
9 to 10 out of 10	4.93	3.68–6.60	<0.001
Who should be part of telemonitoring comparing to ‘just the patient’:
Patient and family member	1.46	1.16–1.84	0.001
Other members of the health team	1.50	1.03–2.16	0.036
How you would like to charge telemonitoring fees compared to no charges
Patient payment	2.63	1.46–4.75	0.001
Insurance company or third party	2.82	1.53–5.20	0.001
Private insurance	2.5	1.22–5.12	0.012
Government insurance	2.21	0.89–5.45	0.086
How much would you like to charge for telemonitoring?
26–75 USD	1.45	1.13–1.86	0.003
> 76 USD	1.57	1.18–2.10	0.002

1–5 means low; 6–8 means intermediate; 9–10 equals to high.

Table 4. Multivariate analysis showing association with high probability on telemonitoring.

Variable	OR	95% CI	p Value
Age <60 years	1.39	1.04–1.86	0.025
Speciality
Cardiology	1.51	1.11–2.04	0.008
General practitioners and internal medicine	1.47	1.04–2.07	0.029
Team working	1.39	0.99–1.94	0.051
Working city (compared to <100.000 inhabitants)	1.96	1.35–2.82	<0.001
Academic activities	1.31	0.99–1.75	0.063
Relevance perception of telemonitoring as complement of face-to-face practice
6 to 8 out of 10	3.71	2.65–5.20	<0.001
9 to 10 out of 10	15.5	10.4–23.1	<0.001
Knowledge or use of a professional remote monitoring platform	2.35	1.70–3.26	<0.001
Currently using a professional platform	1.36	1.04–1.78	0.025
No need training to practice telemonitoring	2.04	1.52–2.72	<0.001
Expectations about patients telemedicine preferences
6 to 8 out of 10	2.69	1.98–3.65	<0.001
9 to 10 out of 10	2.21	1.09–4.45	0.027
How much would you like to charge for telemonitoring?
26–75 USD	1.67	1.22–2.28	0.001
76 to más USD	1.74	1.21–2.49	0.003

1–5 means low; 6–8 means intermediate; 9–10 equals to high.