Telemedicine-Supported Intervention Versus Standard Care for Managing Cardiovascular Risk Factors in a Socially Deprived Urban Population: A Prospective Study

远程医疗支持干预与标准护理在社会经济地位较低的城市人口中管理心血管危险因素的前瞻性研究

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Abstract

Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality, particularly in socioeconomically disadvantaged populations. Telemedicine offers a potential strategy to support risk factor management in such groups with limited access to care. Our aim was to assess the effectiveness of a telemedicine-supported intervention compared to usual care in improving cardiovascular risk parameters among adults from a socially deprived urban population. Materials and Methods: In this controlled intervention study, adult patients with one or more cardiovascular risk factors were recruited from a primary care center in a low-income urban neighborhood in Timişoara, Romania. Participants were allocated to either usual care or a six-month telemedicine-supported intervention group. The intervention consisted of regular phone calls by trained staff focusing on medication adherence, self-monitoring of blood pressure and glucose, smoking cessation, and lifestyle advice. No physical visits were delivered. Primary outcomes included changes in systolic and diastolic blood pressure, fasting glucose, and lipid profile. Data were collected at baseline and at six months. Results: A total of 144 patients were allocated to the telemedicine group and 142 to the usual care group. After 6 months, diastolic blood pressure decreased by 3.9 mmHg in the telemedicine group compared to 0.3 mmHg in the standard care group (p < 0.001). LDL-cholesterol was reduced by 18.0 mg/dL with telemedicine versus 5.7 mg/dL with usual care (p < 0.001). In contrast, fasting glucose improved more in the standard care group (-10.9 mg/dL vs. -2.0 mg/dL, p < 0.001). Patient satisfaction in the telemedicine group was high, with 84% rating the program as very useful. Conclusions: Basic telemedicine-supported interventions may represent a feasible and effective strategy for improving cardiovascular risk factors such as diastolic blood pressure and LDL-cholesterol in socially deprived populations. High satisfaction suggests strong acceptability; however, given the small sample size, short follow-up, and single-center design, these findings should be interpreted cautiously and confirmed in larger studies.

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