RATIONALE: To evaluate the feasibility of a second-opinion consultation in supporting general practitioners (GPs) during the daily diagnosis and therapeutic management of patients with essential hypertension. METHODS: Italian GPs were encouraged to follow-up their patients by the use of the Telemedicine Service. All known hypertensive patients with signs and symptoms (teleconsultation for symptoms) and all asymptomatic patients (teleconsultation for clinical control) undergoing a visit by their GPs were enrolled. During the first visit, the GP performed electrocardiography (ECG), measured blood pressure and required cardiological teleconsultation. RESULTS: 399 GPs examined 1719 consecutive patients (mean age 73±13 years, 38% male). During teleconsultation for a routine control, GPs identified 36% of new episodes of atrial fibrillation in the absence of any symptom and about 70% of patients with uncontrolled blood pressure. In about 50% of the cases, 10 min of teleconsultation helped GP to quicken the solution of the clinical problems, reducing time and number of specialist's visit. In 8% of cases, an emergency department admission was suggested. CONCLUSIONS: Telemedicine applied to hypertensive patients at high risk of cardiovascular problems offers to GPs an easy-to-use tool to control blood pressure by improving connection with second-opinion specialist consultations.
RATIONALE: To evaluate the feasibility of a second-opinion consultation in supporting general practitioners (GPs) during the daily diagnosis and therapeutic management of patients with essential hypertension. METHODS: Italian GPs were encouraged to follow-up their patients by the use of the Telemedicine Service. All known hypertensivepatients with signs and symptoms (teleconsultation for symptoms) and all asymptomatic patients (teleconsultation for clinical control) undergoing a visit by their GPs were enrolled. During the first visit, the GP performed electrocardiography (ECG), measured blood pressure and required cardiological teleconsultation. RESULTS: 399 GPs examined 1719 consecutive patients (mean age 73±13 years, 38% male). During teleconsultation for a routine control, GPs identified 36% of new episodes of atrial fibrillation in the absence of any symptom and about 70% of patients with uncontrolled blood pressure. In about 50% of the cases, 10 min of teleconsultation helped GP to quicken the solution of the clinical problems, reducing time and number of specialist's visit. In 8% of cases, an emergency department admission was suggested. CONCLUSIONS: Telemedicine applied to hypertensivepatients at high risk of cardiovascular problems offers to GPs an easy-to-use tool to control blood pressure by improving connection with second-opinion specialist consultations.