Home blood pressure monitoring ??? One step towards reducing defensive medicine

摘要

Hypertension is one of the major risk factors for developing cardiovascular diseases such as heart failure, stroke, coronary heart disease, and renal failure, and one of the most frequent reasons for access to medical care. In elderly patients, hypertension is usually associated with several concomitant diseases, which leads to polypharmacy, iatrogeny, repeated hospitalizations and un-necessary consultations. Defensive medicine is defined as the ordering of treatments, tests, and procedures for the purpose of protecting the doctor from criticism rather than diagnosing or treating the patient. Our case presentation illustrates defensive medicine applied to an elderly female patient with high blood pressure. What should have been the methods to prevent the delaying of treatment for the main problems (high blood pressure and atrial fibrillation)? A better medical surveillance and monitoring should have been the answer. Use of blood pressure telemonitoring technique might help in improving blood pressure control and adherence, helping the quantification and definition of the psychological trait of the hypertensive patient and preventing defensive medicine expressed by un-necessary hospitalization and interdisciplinary consults.