Long-Term Results of a Digital Hypertension Self-Management Program: Retrospective Cohort Study (Preprint)

Abstract

BACKGROUND Digital health programs that incorporate frequent blood pressure (BP) self-monitoring and comprehensive support for behavior change offer a scalable solution for hypertension (HTN) management. OBJECTIVE We examined the impact of a digital HTN self-management and lifestyle change support program on BP over 12 months. METHODS Data was analyzed from a retrospective observational cohort of commercially insured members (n=1,117) that started the Omada for HTN program between 1/1/19-9/30/21. Paired t-tests and linear regression were used to measure change in SBP over 12 months, by SBP control at baseline (≥130 vs. <130). RESULTS Members were on average 50.9 years old, 50.8% were female, 60.5% white and 70.5% had uncontrolled SBP at baseline (≥130). At 12 months, members with uncontrolled SBP experienced significant reductions in both unadjusted (mean (95%CI): -8.1mmHg (-9.0, -7.1)) and adjusted SBP (-8.0mmHg (-9.0, -7.1)). Members with uncontrolled SBP also had significant reductions in diastolic BP (-4.7mmHg; -5.3, -4.1), weight (-6.5lbs (-7.7, -5.3); 2.7% weight loss) and body mass index (-1.1kg/m2) (-1.3, -0.9)). Those with controlled SBP maintained within BP goal range. Additionally, 48% of members with uncontrolled BP experienced enough change in BP to improve their BP category. CONCLUSIONS This study provides real-world evidence that a comprehensive digital health program involving HTN education, at-home BP monitoring, and behavior change coaching support was effective for self-managing HTN over 12 months.