{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:10:50Z","timestamp":1792221050496,"version":"4.4.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2012,10,1]],"date-time":"2012-10-01T00:00:00Z","timestamp":1349049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Objective:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Hypertension and other noncommunicable diseases represent a growing threat to low\/middle-income countries (LMICs). Mobile health technologies may improve noncommunicable disease outcomes, but LMICs lack resources to provide these services. We evaluated the efficacy of a cloud computing model using automated self-management calls plus home blood pressure (BP) monitoring as a strategy for improving systolic BPs (SBPs) and other outcomes of hypertensive patients in two LMICs.<\/jats:italic>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Subjects and Methods:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">This was a randomized trial with a 6-week follow-up. Participants with high SBPs (\u2265140\u2009mm Hg if nondiabetic and \u2265130\u2009mm Hg if diabetic) were enrolled from clinics in Honduras and Mexico. Intervention patients received weekly automated monitoring and behavior change telephone calls sent from a server in the United States, plus a home BP monitor. At baseline, control patients received BP results, hypertension information, and usual healthcare. The primary outcome, SBP, was examined for all patients in addition to a preplanned subgroup with low literacy or high hypertension information needs. Secondary outcomes included perceived health status and medication-related problems.<\/jats:italic>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Of the 200 patients recruited, 181 (90%) completed follow-up, and 117 of 181 had low literacy or high hypertension information needs. The median annual income was $2,900 USD, and average educational attainment was 6.5 years. At follow-up intervention patients' SBPs decreased 4.2\u2009mm Hg relative to controls (95% confidence interval \u22129.1, 0.7;<\/jats:italic>\n                    p\n                    <jats:italic toggle=\"yes\">=0.09). In the subgroup with high information needs, intervention patients' average SBPs decreased 8.8\u2009mm Hg (\u221214.2, \u22123.4,<\/jats:italic>\n                    p\n                    <jats:italic toggle=\"yes\">=0.002). Compared with controls, intervention patients at follow-up reported fewer depressive symptoms (<\/jats:italic>\n                    p\n                    <jats:italic toggle=\"yes\">=0.004), fewer medication problems (<\/jats:italic>\n                    p\n                    <jats:italic toggle=\"yes\">&lt;0.0001), better general health (<\/jats:italic>\n                    p\n                    <jats:italic toggle=\"yes\">&lt;0.0001), and greater satisfaction with care (<\/jats:italic>\n                    p\n                    <jats:italic toggle=\"yes\">\u22640.004).<\/jats:italic>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    <\/jats:bold>\n                    <jats:italic toggle=\"yes\">Automated telephone care management plus home BP monitors can improve outcomes for hypertensive patients in LMICs. A cloud computing model within regional telecommunication centers could make these services available in areas with limited infrastructure for patient-focused informatics support.<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1089\/tmj.2011.0271","type":"journal-article","created":{"date-parts":[[2012,10,12]],"date-time":"2012-10-12T17:30:01Z","timestamp":1350063001000},"page":"613-620","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":148,"title":["Hypertension Management Using Mobile Technology and Home Blood Pressure Monitoring: Results of a Randomized Trial in Two Low\/Middle-Income Countries"],"prefix":"10.1177","volume":"18","author":[{"given":"John D.","family":"Piette","sequence":"first","affiliation":[{"name":"Ann Arbor VA Healthcare System"},{"name":"Department of Internal Medicine, Ann Arbor, Michigan."},{"name":"Yojoa Community Health Systems","place":["Honduras"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hema","family":"Datwani","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Gaudioso","sequence":"additional","affiliation":[{"name":"University of Michigan School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie M.","family":"Foster","sequence":"additional","affiliation":[{"name":"University of Michigan School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joslyn","family":"Westphal","sequence":"additional","affiliation":[{"name":"University of Michigan School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Perry","sequence":"additional","affiliation":[{"name":"University of Michigan School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Rodr\u00edguez-Salda\u00f1a","sequence":"additional","affiliation":[{"name":"Remedi Medical Research and Development","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton O.","family":"Mendoza-Avelares","sequence":"additional","affiliation":[{"name":"Yojoa Community Health Systems","place":["Honduras"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolle","family":"Marinec","sequence":"additional","affiliation":[{"name":"Ann Arbor VA Healthcare System"},{"name":"Yojoa Community Health Systems","place":["Honduras"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,10,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17741-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/450494a"},{"key":"e_1_3_3_4_2","unstructured":"World Health Organization. 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