Remote patient monitoring led to earlier antihypertensive medication changes, with 50% of patients changing within 228 days compared to 530 days for controls.
Does remote patient monitoring facilitate quicker and more frequent antihypertensive medication changes in patients with hypertension?
Remote patient monitoring for hypertension facilitates faster and more frequent medication adjustments, allowing for tailored prescribing based on specific phenotypes like white-coat and masked hypertension.
Absolute Event Rate: 0% vs 0%
Abstract Background Remote patient monitoring (RPM) includes home blood pressure (BP) measurement with readings sent directly to the electronic health record (EHR). We hypothesize that RPM facilitates quicker, more frequent, more appropriate antihypertensive medication changes. Methods Patients with hypertension in 6 primary care clinics were prescribed RPM between November 2020 and August 2021 (N = 288) and matched to 4 control patients (N = 1152). Office and RPM BP readings and medication data over 18 months were extracted from the EHR. RPM patients were classified as baseline-controlled (office and RPM 130/80 mmHg), sustained (office and RPM ≥130 and/or ≥80), white-coat (office ≥130 and/or ≥80, RPM 130/80), or masked hypertension (office 130/80, RPM ≥130 and/or ≥80). Results RPM patients had earlier first antihypertensive medication changes, with half of RPM patients having ≥1 change by 228 days versus 530 days for controls. RPM patients had more total medication changes, with 25% of RPM patients having ≥4 (median 1; 25th-75th percentiles 0-4) changes versus ≥2 (median 1; 0-2) changes in controls. Compared to baseline sustained hypertension RPM users, white-coat hypertension users were less likely to have ≥1 medication increase (24% N = 11 versus 53% N = 74, P = .001) within 12 months. Compared to baseline-controlled RPM users, masked hypertension users were less likely to have ≥1 medication decrease (0% N = 0 versus 44% N = 8; P = .003) within 12 months. Conclusions Even without additional staff dedicated to medication adjustment, RPM facilitated quicker medication changes, more total changes, and differential prescribing decisions for white-coat and masked hypertension patients supporting RPM use in primary care. Clinical trial registration number ClinicalTrials.gov identifier: NCT05562921.
Winkler et al. (Sat,) reported a other. Remote patient monitoring led to earlier antihypertensive medication changes, with 50% of patients changing within 228 days compared to 530 days for controls.
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