OBJECTIVES: This study examines use of telemedicine services and health outcomes in patients with hypertension (HTN) in pre- and post-COVID 19 periods in the US.

METHODS: A retrospective analysis, using Optum® de-identified Electronic Health Record dataset, was done among hypertensive patients on Medicare plans in three different time periods: 1st Jan 2018 - 30th June 2018, 1st Jan - 30th June 2019, and 1st Jan - 30th June 2020 (first two time periods are pre-COVID 19 and the last one is post-COVID 19). The date of first EHR with mention of HTN diagnosis was considered index date. Study participants were categorized into those who used only telemedicine services (Telemedicine group); only other places of service like outpatient, inpatient, or office (Other POS group); and those who used both telemedicine and other places of service (Both POS groups). Patients were followed for 6-months post-index to determine use of anti-HTN medications, resource utilization, and healthcare outcomes.

RESULTS: Fewer than 100 patients in each study period belonged to Telemedicine group. Majority (55%) patients in 2018 (pre-COVID 19) belonged to Other POS group, but in 2020 (post-COVID 19) majority (61%) patients belonged to Both POS group. About 70% patients in each of three groups were prescribed anti-HTN drugs and adherence was >90%. About ~60% patients in Telemedicine group had 2-6 healthcare encounters while ~80% in Other POS group and ~95% in Both POS groups had >6 healthcare encounters during follow-up period. Significantly more patients in Both POS groups received anti-HTN nutritional counseling as compared to other two groups. Also, blood pressure was controlled in significantly higher percentage of patients in Both POS groups as compared to other two groups.

CONCLUSIONS: Patients who use telemedicine and other places of service are more likely to receive anti-HTN nutritional counseling and have better blood pressure control.