Key result
Remote blood pressure monitoring was acceptable to patients and health professionals and improved motivation and blood pressure control, despite feasibility challenges such as technical difficulties and data overload.
Why the study?
Hypertension affects nearly 50% of US adults with only 30% achieving controlled BP, prompting evaluation of the acceptability, appropriateness, feasibility, and sustainability of remote BP monitoring in a precision health pilot.
Does remote blood pressure monitoring improve the acceptability, appropriateness, feasibility, and sustainability of hypertension management among patients and health professionals?
Does remote blood pressure monitoring improve the acceptability, appropriateness, feasibility, and sustainability of hypertension management among patients and health professionals?
Remote blood pressure monitoring is acceptable and appropriate for hypertension management, but requires team-based care and improved EMR integration to overcome feasibility challenges.
Remote BP monitoring was acceptable in the Humanwide pilot; leaves open whether it improves control in routine primary care.
BACKGROUND: Hypertension is the most prevalent and important risk factor for cardiovascular disease, affecting nearly 50% of the US adult population; however, only 30% of these patients achieve controlled blood pressure (BP). Incorporating strategies into primary care that take into consideration individual patient needs, such as remote BP monitoring, may improve hypertension management. OBJECTIVE: From March 2018 to December 2018, Stanford implemented a precision health pilot called Humanwide, which aimed to leverage high-technology and high-touch medicine to tailor individualized care for conditions such as hypertension. We examined multi-stakeholder perceptions of hypertension management in Humanwide to evaluate the program's acceptability, appropriateness, feasibility, and sustainability. METHODS: We conducted semistructured interviews with 16 patients and 15 health professionals to assess their experiences with hypertension management in Humanwide. We transcribed and analyzed the interviews using a hybrid approach of inductive and deductive analysis to identify common themes around hypertension management and consensus methods to ensure reliability and validity. RESULTS: A total of 63% (10/16) of the patients and 40% (6/15) of the health professionals mentioned hypertension in the context of Humanwide. These participants reported that remote BP monitoring improved motivation, BP control, and overall clinic efficiency. The health professionals discussed feasibility challenges, including the time needed to analyze BP data and provide individualized feedback, integration of BP data, technological difficulties with the BP cuff, and decreased patient use of remote BP monitoring over time. CONCLUSIONS: Remote BP monitoring for hypertension management in Humanwide was acceptable to patients and health professionals and appropriate for care. Important challenges need to be addressed to improve the feasibility and sustainability of this approach by leveraging team-based care, engaging patients to sustain remote BP monitoring, standardizing electronic medical record integration of BP measurements, and finding more user-friendly BP cuffs.
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Baratta et al. (2022) studied Hypertension (n=31). Remote blood pressure monitoring (Humanwide pilot) was evaluated on Multi-stakeholder perceptions of hypertension management (acceptability, appropriateness, feasibility, and sustainability). Remote blood pressure monitoring was acceptable to patients and health professionals and improved motivation and blood pressure control, despite feasibility challenges such as technical difficulties and data overload.
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