title: Factors affecting frequency of patient use of Internet-based telemedicine to manage cardiovascular disease risk.
abstract: We examined the frequency of use by patients of a web-based reporting system to monitor and control cardiovascular disease (CVD) risk factors. A total of 192 patients with intermediate or high CVD risk were categorized into four quartiles based on their frequency of use of the telemedicine reporting system over one year. The lowest frequency users (Quartile I) averaged 17 reporting days in one year and the highest frequency users (Quartile IV) averaged 211 reporting days in one year. Factors associated with more frequent use were overall knowledge of CVD (P = 0.014), blood lipids (P = 0.017), smoking (P = 0.036), higher scores in medication self-efficacy (P = 0.016) and higher income (P = 0.002). All quartiles showed trends of decreasing systolic blood pressure from hypertensive (≥140 mm Hg) to pre-hypertensive (<140) ranges. Patients were able to lower CVD risk with as few as two transmissions per month using the telemedicine system. Telemedicine reporting coupled with self-assessment of health status can promote a strong patient-provider partnership for managing the chronic risk factors of CVD.
authors.affiliation: Temple University Medical Center, Philadelphia, USA and Geisinger Medical Center, Danville, Philadelphia, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Kothapalli
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Bove
authors.forename: William P
authors.initials: WP
authors.lastname: Santamore
authors.forename: Carol
authors.initials: C
authors.lastname: Homko
authors.forename: Abul
authors.initials: A
authors.lastname: Kashem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D019468:Disease Management; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D006973:Hypertension; D007182:Income; D020407:Internet; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D010361:Patients / Q000523:psychology*; D012307:Risk Factors; D020377:Self Efficacy; D012651:Self Medication; D012907:Smoking / Q000009:adverse effects; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult
chemical_list: D008055:Lipids