The Diagnosis Center of Cardiology in Rabat welcomes patients from different regions of Morocco. The long-distance travel, difficulty of access to care in rural Morocco, To avoid this problem, we followed our patients by social messaging platforms, then judged the effectiveness of this method a year later.

This is a prospective, comparative analytic study of 200 patients under oral anticoagulant therapy based on vitamin K antagonists (VKA), followed in cardiology consultation, all of whom come from rural areas where access to care is difficult. These 200 patients were followed during 1 year in consultation, 100 of them (group 1) in standard consultation according to the appointments elaborated by the computerized system of the Diagnosis Center. The other 100 (group 2) were followed, moreover, by their doctor via telephone. One year later, the patients of the 2nd group (group followed by telephone) were well anticoagulated most of the times with more frequent INR tests; 1305 INR performed by the 2nd group (1.09 per patient per month) compared with 500 INR by the 1st group (0.41 per patient per month). The number of complications was lower in the 2nd group as 5 patients presented a symptomatic overdose to anticoagulants and have evolved well, versus 12 for the 1st group, 4 of whom required hospitalization in the Intensive Care Unit for serious bleeding events, one of them has deceased and another had a hemostasis gastrectomy. Four patients in the first group had embolic events: 1 ischemic stroke with sequelae, 1 transient ischemic attack (TIA), and 2 prosthetic thromboses with one treated medically and the other surgically. Transportation expenses of the 2nd group were much smaller.

Health policy should consider telemedicine as a solution for a better management of the Moroccan population and as a solution for health problems in the framework of the citizen approximation initiative.