Telemedicine: The role of specialist second opinion for GPs in the care of hypertensive patients

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.