Key result
A mobile health intervention using prompted BP self-monitoring and text messages significantly reduced systolic blood pressure by a mean of 9.1 mm Hg (95% CI 1.1-17.6) in ED patients.
Why the study?
The study aimed to evaluate the feasibility of an ED-initiated text messaging intervention for prompted home BP self-monitoring in patients with persistent hypertension, and to explore its effect on systolic BP.
Does a mobile health text messaging intervention reduce systolic blood pressure in emergency department patients with persistent hypertension?
RCT (n=104)
randomized
Does a mobile health text messaging intervention reduce systolic blood pressure in emergency department patients with persistent hypertension?
Mean Difference: 9.1 (95% CI 1.1–17.6)
An emergency department-initiated mobile health text messaging intervention is feasible and associated with a clinically meaningful reduction in systolic blood pressure among patients with persistent hypertension.
Supports ED-initiated mHealth for persistent hypertension; extends prior outpatient evidence to acute care settings.
OBJECTIVES: We aimed to assess the feasibility of a text messaging intervention by determining the proportion of emergency department (ED) patients who responded to prompted home blood pressure (BP) self-monitoring and had persistent hypertension. We also explored the effect of the intervention on systolic blood pressure (sBP) over time. METHODS: We conducted a randomized, controlled trial of ED patients with expected discharge to home with elevated BP. Participants were identified by automated alerts from the electronic health record. Those who consented received a BP cuff to take home and enrolled in the 3-week screening phase. Text responders with persistent hypertension were randomized to control or weekly prompted BP self-monitoring and healthy behavior text messages. RESULTS: Among the 104 patients enrolled in the ED, 73 reported at least one home BP over the 3-week run-in (screening) period. A total of 55 of 73 reported a home BP of ≥140/90 and were randomized to SMS intervention (n = 28) or control (n = 27). The intervention group had significant sBP reduction over time with a mean drop of 9.1 mm Hg (95% confidence interval = 1.1 to 17.6). CONCLUSIONS: The identification of ED patients with persistent hypertension using home BP self-monitoring and text messaging was feasible. The intervention was associated with a decrease in sBP likely to be clinically meaningful. Future studies are needed to further refine this approach and determine its efficacy.
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Dome et al. (2019) conducted an RCT in Elevated blood pressure / persistent hypertension (n=104). Mobile health intervention (weekly prompted BP self-monitoring and healthy behavior text messages) vs. Control was evaluated on Systolic blood pressure (sBP) reduction over time (mean drop of 9.1 mm Hg, 95% CI 1.1 to 17.6). A mobile health intervention using prompted BP self-monitoring and text messages significantly reduced systolic blood pressure by a mean of 9.1 mm Hg (95% CI 1.1-17.6) in ED patients.
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