Blood Pressure Outcomes Following a Home Blood Pressure Monitoring Program in a Large Integrated us Health System

BACKGROUND: Home blood pressure telemonitoring (HBPT) can empower patients to participate in their healthcare and reduce office BP. Evidence that BP control can be sustained following HBPT is scarce. We examined the effects of an HBPT program on BP outcomes. METHODS: We included patients with uncontrolled hypertension enrolled in an HBPT program at an integrated healthcare system between November 2019 and June 2022. Clinicians enrolled patients and provided them with a BP device and a mobile application. We examined clinic BP before and after enrollment in HBPT, and sustained clinic BP control (last clinic BP < 140/90 mmHg) within 12 months following graduation from the program (home BP < 135/85 mmHg). Multivariable robust Poisson regression was used to identify factors associated with sustained clinic BP control. RESULTS: Overall, 3574 patients were enrolled and 59% consented to participation. Among those who consented, 3% did not submit >1 home BP, 37% were actively enrolled, 30% disenrolled without meeting home BP control and 30% graduated by meeting home BP control. Among 527 patients who graduated and had ≥1 follow-up clinic BP, 396 (75%) sustained clinic BP control within 12 months while mean clinic SBP and DBP was reduced by 16.3 (95% CI: -18.3, -14.4) mmHg and 10.0 (95% CI: -11.1, -8.9) mmHg, respectively (P < 0.0001 for both) compared with the last clinic BP prior to HBPT enrollment. CONCLUSIONS: The HBPT program in this healthcare system demonstrates potential; however, effective strategies are needed to facilitate enrollment and consent of patients and to scale the program.