Implementing Equitable Hypertension Care Using a Remote Patient Monitoring Program

Central Illustration. Implementing Equitable Hypertension Care Using a Remote Patient Monitoring Program: A Mixed Methods Study This study employed a convergent mixed methods design to assess the overlap between an observational analysis of sociodemographic variables with the descriptive insights from key program staff. The findings will guide future qualitative assessment of patients’ perspectives and will lead to the hybrid implementation/effectiveness testing of enhanced remote patient monitoring (RPM). ADI = Area Deprivation Index; other abbreviation as in Figure 1.

Figure 1. Cohort Flow Diagram of Remote Patient Monitoring Program Patient Participation BP = blood pressure; RPM = remote patient monitoring.

Figure 2. Blood Pressure Results Stratified by Level of Remote Patient Monitoring Program Engagement (A) shows systolic blood pressure (SBP) trends over the course of RPM. (B) shows diastolic blood pressure (DBP) trends over the course of RPM. (C) shows SBP trends over the subsequent 180 days after RPM completion. (D) shows DBP trends over the subsequent 180 days after RPM completion. Abbreviation as in Figure 1.

Figure 3. Kaplan-Meier Curves for Probability of Achieving Normotension by Level of Remote Patient Monitoring Program Engagement The mean time to normotension for each group is indicated by the diagonal lines. N = 872 (low engagement = 525, high engagement = 347).

Figure 4. Sankey Diagram of Qualitative Codes Qualitative coding demonstrated 33 key takeaways that were coded based on interview guide questions. These codes reflected staff roles, patient-level constructs, staff-level constructs, the role of technology, notable barriers and facilitators to RPM use, and possible ways to improve future implementation. These findings were further characterized using a validated implementation science framework to reflect innovation, settings, individuals, and intervention implementation. EHR = electronic health record; other abbreviations as in Figure 1.