Key result
Compared with nurse practitioners and physician assistants, primary care physicians were more likely to advise self-measured blood pressure monitoring (aPR 1.28) and increase telemedicine use (aPR 1.23) for hypertension early in the COVID-19 pandemic.
Why the study?
Telemedicine and self-measured blood pressure can be used for remote hypertension monitoring to promote control while decreasing SARS-CoV-2 exposure risk.
Cross-Sectional (n=1,502)
Relative Risk: 1.28 (95% CI 1.11–1.47)
p-value: p=<0.05
During the early COVID-19 pandemic, clinicians frequently adopted telemedicine and self-measured blood pressure monitoring for hypertension, though adoption varied by clinician type.
Survey data indicate rapid uptake of telemedicine and SMBP during early COVID-19; leaves open effects on sustained hypertension control.
BACKGROUND: Clinical practices can use telemedicine and other strategies (e.g., self-measured blood pressure [SMBP]) for remote monitoring of hypertension to promote control while decreasing risk of exposure to SARS-CoV-2, the virus that causes COVID-19. METHODS: The DocStyles survey collected data from primary care providers (PCPs), obstetricians-gynecologists (OB/GYNs), and nurse practitioners/physician assistants (NP/PAs) in fall 2020 (n = 1,502). We investigated clinical practice changes for monitoring hypertension that were implemented early in the COVID-19 pandemic and examined differences by clinician and practice characteristics (P < 0.05). RESULTS: Overall, 369 (24.6%) of clinicians reported their clinical practices made no changes in monitoring hypertension early in the pandemic, 884 (58.9%) advised patients to monitor blood pressure at home or a pharmacy, 699 (46.5%) implemented or increased use of telemedicine for blood pressure monitoring visits, and 545 (36.3%) reduced the frequency of office visits for blood pressure monitoring. Compared with NP/PAs, PCPs were more likely to advise SMBP monitoring (adjusted prevalence ratios [aPR] 1.28, 95% confidence intervals [CI] 1.11-1.47), implement or increase use of telemedicine (aPR 1.23, 95% CI 1.04-1.46), and reduce the frequency of office visits (aPR 1.37, 95% CI 1.11-1.70) for blood pressure monitoring, and less likely to report making no practice changes (aPR 0.63, 95% CI 0.51-0.77). CONCLUSIONS: We noted variation in clinical practice changes by clinician type and practice characteristics. Clinical practices may need additional support and resources to fully maximize telemedicine and other strategies for remote monitoring of hypertension during pandemics and other emergencies that can disrupt routine health care.
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Robbins et al. (2022) conducted a cross-sectional in Hypertension (n=1,502). Primary care physician specialty vs. Nurse practitioner or physician assistant was evaluated on Advised patients to monitor blood pressure at home or a pharmacy (aPR 1.28, 95% CI 1.11-1.47, p=<0.05). Compared with nurse practitioners and physician assistants, primary care physicians were more likely to advise self-measured blood pressure monitoring (aPR 1.28) and increase telemedicine use (aPR 1.23) for hypertension early in the COVID-19 pandemic.
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