Improving Blood Pressure Control Using Smart Technology

Ciemins, Elizabeth L.; Arora, Anupama; Coombs, Nicholas; Holloway, Barbara; Mullette, Elizabeth; Garland, Robin; Bishop-Green, Shannon Walsh; Penso, Jerry; Coon, Patricia J.

doi:10.1089/tmj.2017.0028

Cited by 36 publications

(28 citation statements)

References 17 publications

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“…The mean BP levels improved from 42% to 67% among patients on HBPM compared with 59% to 67% among controls (p < 0.01). 130 The INTERACT study was a randomized clinical trial in which 303 patients using BP and/or lipid-lowering medications were randomized to receive or not receive text messages. The group that received text messages improved medication adherence at 6 months compared with the group that did not receive messages.…”

Section: In Hypertensionmentioning

confidence: 99%

Guidelines os the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019

Lopes¹,

Oliveira²,

Ribeiro³

et al. 2019

Arquivos Brasileiros De Cardiologia

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Section: In Hypertensionmentioning

confidence: 99%

Guidelines os the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019

Lopes¹,

Oliveira²,

Ribeiro³

et al. 2019

Arquivos Brasileiros De Cardiologia

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“…Like other recent digital health interventions for hypertension that use home blood pressure monitors, patients found BPTrack relatively easy to learn and use [ 19 ]. Complaints noted by patient participants largely related to issues that could be easily addressed through refining the app itself, as well as usage protocol.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Feasibility, Acceptability, and Efficacy of a Clinical Pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: Mixed Methods Pilot Study

Buis¹,

Roberson²,

Kadri³

et al. 2020

J Med Internet Res

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Background Hypertension is a prevalent and costly burden in the United States. Clinical pharmacists within care teams provide effective management of hypertension, as does home blood pressure monitoring; however, concerns about data quality and latency are widespread. One approach to close the gap between clinical pharmacist intervention and home blood pressure monitoring is the use of mobile health (mHealth) technology. Objective We sought to investigate the feasibility, acceptability, and preliminary effectiveness of BPTrack, a clinical pharmacist-led intervention that incorporates patient- and clinician-facing apps to make electronically collected, patient-generated data available to providers in real time for hypertension management. The patient app also included customizable daily medication reminders and educational messages. Additionally, this study sought to understand barriers to adoption and areas for improvement identified by key stakeholders, so more widespread use of such interventions may be achieved. Methods We conducted a mixed methods pilot study of BPTrack, to improve blood pressure control in patients with uncontrolled hypertension through a 12-week pre-post intervention. All patients were recruited from a primary care setting where they worked with a clinical pharmacist for hypertension management. Participants completed a baseline visit, then spent 12 weeks utilizing BPTrack before returning to the clinic for follow-up. Collected data from patient participants included surveys pre- and postintervention, clinical measures (for establishing effectiveness, with the primary outcome being a change in blood pressure and the secondary outcome being a change in medication adherence), utilization of the BPTrack app, interviews at follow-up, and chart review. We also conducted interviews with key stakeholders. Results A total of 15 patient participants were included (13 remained through follow-up for an 86.7% retention rate) in a single group, pre-post assessment pilot study. Data supported the hypothesis that BPTrack was feasible and acceptable for use by patient and provider participants and was effective at reducing patient blood pressure. At the 12-week follow-up, patients exhibited significant reductions in both systolic blood pressure (baseline mean 137.3 mm Hg, SD 11.1 mm Hg; follow-up mean 131.0 mm Hg, SD 9.9 mm Hg; P=.02) and diastolic blood pressure (baseline mean 89.4 mm Hg, SD 7.7 mm Hg; follow-up mean 82.5 mm Hg, SD 8.2 mm Hg; P<.001). On average, patients uploaded at least one blood pressure measurement on 75% (SD 25%) of study days. No improvements in medication adherence were noted. Interview data revealed areas of improvement and refinement for the patient experience. Furthermore, stakeholders require integration into the electronic health record and a modified clinical workflow for BPTrack to be truly useful; however, both patients and stakeholders perceived benefits of BPTrack when used within the context of a clinical relationship. Conclusions Results demonstrate that a pharmacist-led mHealth intervention promoting home blood pressure monitoring and clinical pharmacist management of hypertension can be effective at reducing blood pressure in primary care patients with uncontrolled hypertension. Our data also support the feasibility and acceptability of these types of interventions for patients and providers. Trial Registration ClinicalTrials.gov NCT02898584; https://clinicaltrials.gov/ct2/show/NCT02898584 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8059

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“…mHealth and apps that assess blood pressure are progressively gaining a fundamental role in the management of hypertension with the potential to improve the quality of managed care by offering additional advantages, especially when it comes to blood pressure self-measurement. Advantages could include assisting in lowering blood pressure [ 3 , 40 , 41 ]; enabling individuals to have 24-hour access to detailed and personalized blood pressure information [ 40 , 42 ]; improving adherence to treatment [ 3 , 43 ]; providing information to facilitate diagnostic and therapeutic decisions [ 40 , 41 , 43 , 44 ]; improving patient knowledge of blood pressure, lifestyle, and risk factors that may accompany hypertension [ 40 , 42 , 43 ]; more effectively preventing cardiovascular complications [ 43 ]; or health cost savings by avoiding unnecessary hypertensive treatment and reducing the number of visits to the clinic [ 3 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

QardioArm Blood Pressure Monitoring in a Population With Type 2 Diabetes: Validation Study

Mazoteras‐Pardo¹,

Becerro-de-Bengoa-Vallejo²,

Iglesias³

et al. 2020

J Med Internet Res

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Background Home blood pressure monitoring has many benefits, even more so, in populations prone to high blood pressure, such as persons with diabetes. Objective The purpose of this research was to validate the QardioArm mobile device in a sample of individuals with noninsulin-dependent type 2 diabetes in accordance with the guidelines of the second International Protocol of the European Society of Hypertension. Methods The sample consisted of 33 patients with type 2 diabetes. To evaluate the validity of QardioArm by comparing its data with that obtained with a digital sphygmomanometer (Omron M3 Intellisense), two nurses collected diastolic blood pressure, systolic blood pressure, and heart rate with both devices. Results The analysis indicated that the test device QardioArm met all the validation requirements using a sample population with type 2 diabetes. Conclusions This paper reports the first validation of QardioArm in a population of individuals with noninsulin-dependent type 2 diabetes. QardioArm for home monitoring of blood pressure and heart rate met the requirements of the second International Protocol of the European Society of Hypertension.

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Improving Blood Pressure Control Using Smart Technology

Cited by 36 publications

References 17 publications

Guidelines os the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019

Guidelines os the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019

Understanding the Feasibility, Acceptability, and Efficacy of a Clinical Pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: Mixed Methods Pilot Study

QardioArm Blood Pressure Monitoring in a Population With Type 2 Diabetes: Validation Study

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