Telephone follow-up linked to poorer blood pressure control in Chinese primary care cohort

Telephone follow-up was associated with lower odds of blood pressure control than outpatient follow-up among older patients with hypertension in a longitudinal observational study of primary care records in China. The study abstract reports an odds ratio of 0.836 for achieving control during telephone follow-up, with the association remaining statistically significant after adjustment for a composite measure of good management.

Researchers constructed the cohort from electronic health record data collected from 2013 through 2024. Eligible patients had hypertension and completed at least two follow-up visits. Follow-up modality was treated as a time-varying exposure: the modality recorded at one visit was used to predict blood pressure outcomes at the next visit. The investigators used multiple imputation to address missing baseline covariates and stabilized inverse probability of treatment weights to estimate marginal structural models that accounted for time-varying confounding. Weighted logistic regression assessed the association between follow-up modality and blood pressure control, while weighted linear models examined changes in systolic and diastolic blood pressure.

According to the abstract, telephone follow-up was also associated with a lower likelihood of meeting the study’s composite good-management indicator, with an odds ratio of 0.500 and p<0.001. Adjusting for that indicator attenuated the association between telephone follow-up and blood pressure control to an odds ratio of 0.863, though it remained statistically significant at p<0.05. For continuous outcomes, telephone follow-up was associated with systolic blood pressure that was 0.769 mmHg higher and diastolic blood pressure that was 0.714 mmHg lower per follow-up interval; both associations had p<0.001.

The findings point to differences in follow-up intensity as a possible partial explanation for the observed association, as stated in the abstract. They do not establish that telephone follow-up caused worse outcomes. The design was observational, the reported evidence comes from an abstract of an accepted article that the publisher says may undergo further edits, and residual confounding or selection processes cannot be ruled out from the information provided. The results therefore describe adjusted associations in older Chinese primary care patients with hypertension rather than a causal or clinical advantage of either follow-up method.

Subject of Research: Associations between follow-up modality and blood pressure control among older Chinese primary care patients with hypertension

Article Title: Outpatient versus telephone follow-up and blood pressure control in China: a longitudinal study in primary care

Article References: Chen, Y., Shen, Q., Jin, C., Wang, X., Wang, Z., Li, Y., & Yang, H. (2026). Outpatient versus telephone follow-up and blood pressure control in China: a longitudinal study in primary care. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15702-9

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15702-9

Keywords: hypertension, blood pressure control, telephone follow-up, outpatient care, primary care, China, electronic health records, longitudinal cohort, older adults, Outpatient, versus, telephone