Feasibility and acceptability of a remote blood pressure monitoring pharmacist-led telehealth programme in an emergency department transition care clinic: a pilot randomised controlled trial

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Elevated blood pressure / Hypertension (SBP ≥130 mm Hg or DBP ≥80 mm Hg, not exceeding 160/100 mm Hg) (n=24). Intervention: Remote blood pressure monitoring (Withings BPM Connect Pro) with weekly pharmacist-led telehealth visits vs. Usual emergency department postdischarge clinic (ED-PDC) care with hypertension education. Primary outcome: Feasibility (recruitment rate, 12-week retention rate, and intervention fidelity) and exploratory change in clinic systolic blood pressure at 12 weeks (MD 0.5 mm Hg, 95% CI -25.7 to 26.7).

Q: What does this research mean for the field?

A pharmacist-led remote blood pressure monitoring telehealth program integrated into an emergency department postdischarge clinic is feasible and acceptable, achieving an 88.9% recruitment rate, 67% retention, and substantial within-group blood pressure reductions. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Lama Ghazi; Paulina Gonzalez-Flores; Emily Green Vance; Quinn H Short; Tapan S. Mehta; LR Hearld; Shoaib Mahmood; Javier A. Neyra; M J Mugavero

doi:10.1136/bmjopen-2026-121681

October 1, 2026BMJ OpenOpen Access

Feasibility and acceptability of a remote blood pressure monitoring pharmacist-led telehealth programme in an emergency department transition care clinic: a pilot randomised controlled trial

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Key result

Pharmacist-led remote BP monitoring proves feasible but fails to improve 12-week SBP over usual care.

MD −0.5 mm Hg
95% CI -25.7 to 26.7
n=24

Figures

Why the study?

The feasibility, fidelity, acceptability, and preliminary effects on systolic blood pressure of a pharmacist-led remote blood pressure monitoring telehealth intervention in an emergency department postdischarge clinic needed evaluation.

Does a pharmacist-led remote blood pressure monitoring telehealth intervention demonstrate feasibility, acceptability, and preliminary systolic blood pressure reduction compared to usual care in adults with elevated blood pressure without a primary care provider presenting to an emergency department postdischarge clinic?

Key Points

To evaluate the feasibility, fidelity, and acceptability of a pharmacist-led remote blood pressure monitoring telehealth intervention in an emergency department postdischarge clinic, along with its preliminary effects on systolic blood pressure over 12 weeks.
Pilot parallel-group (1:1) randomized controlled trial conducted between July 2024 and January 2025 at an academically affiliated emergency department postdischarge clinic in Alabama, USA (NCT06247111).
Enrolled 24 adults (12 per arm) with systolic blood pressure of 130–160 mm Hg who lacked an established primary care provider, predominantly Black (71%) with a mean age of 48.4±12.8 years.
Participants were randomized to receive remote blood pressure monitoring with weekly pharmacist telehealth visits or usual postdischarge care, with both groups completing a 12-week in-person follow-up.
Of 27 screened patients, 24 were randomized (88.9% recruitment rate) and 16 completed the 12-week visit (67% retention; n=8 per arm); intervention participants completed a mean of 10.6±3.3 of 12 planned pharmacist visits.
Acceptability and feasibility ratings were high among intervention participants (AIM 4.69±0.88, IAM 4.75±0.71, FIM 4.78±0.41 on a 1–5 scale).
Mean systolic blood pressure decreased from 153.5±15.8 to 128.9±21.0 mm Hg in the intervention arm (p=0.024) and from 158.1±21.9 to 133.0±21.6 mm Hg in usual care (p=0.003), with a between-group difference of 0.5 mm Hg (95% CI −25.7 to 26.7); 75% (6/8) versus 50% (4/8) achieved systolic blood pressure ≤130 mm Hg.

Study Design

Type

RCT (n=24)

Blinding

Open-label

Randomization

1:1 allocation ratio using permuted blocks of sizes 2 and 4

Multicenter

No

Structured PICO

Does a pharmacist-led remote blood pressure monitoring telehealth intervention demonstrate feasibility, acceptability, and preliminary systolic blood pressure reduction compared to usual care in adults with elevated blood pressure without a primary care provider presenting to an emergency department postdischarge clinic?

P

Population

24 predominantly Black adults (mean age 48.4 years, 37.5% female) with elevated blood pressure (130–160/80–100 mm Hg) and no established primary care provider presenting to an emergency department postdischarge clinic in the United States, followed for 12 weeks.

I

Intervention

Remote blood pressure monitoring (RBPM) using an FDA-approved upper-arm device (Withings BPM Connect Pro) with instructions to measure BP twice in the morning and twice in the evening daily, automated daily text message reminders, and weekly pharmacist-led telehealth visits (for BP review and physician co-approved medication management/titration) over 12 weeks, alongside baseline hypertension education and home BP measurement infographics.

C

Comparator

Usual emergency department postdischarge clinic (ED-PDC) care, receiving baseline hypertension education, home BP measurement infographics, and a 12-week in-person follow-up visit.

O

Outcome

Feasibility outcomes over 12 weeks: (1) recruitment rate (proportion of eligible patients who consented and were randomised); (2) 12-week retention (completion of the 12-week research visit with clinic BP measurement); and (3) fidelity of intervention delivery (proportion of weekly pharmacist visits completed and proportion of visits with BP reviewed).

Main Result

Mean Difference: 0.5 (95% CI -25.7–26.7)

Absolute Event Rate: -22.4% vs -21.9%

Integrating a pharmacist-led remote blood pressure monitoring telehealth programme into an emergency department postdischarge clinic is feasible and highly acceptable among underserved patients without a primary care provider, supporting a larger confirmatory trial.

Limitations

Small pilot sample size (n=24, 12 per arm) not powered for between-arm comparisons
Open-label design without blinding of participants, pharmacists, or outcome assessors
33% overall attrition rate (16/24 completed the 12-week in-person visit)
Single-center design at an urban academic medical center limiting generalizability
Compensation differential between arms (US$435 in RBPM vs US$75 in usual care)
Requirement for smartphone with video capability and daytime availability excluding shift workers
Conducted at a single emergency department postdischarge clinic
Open-label design without blinding of participants, pharmacists, or outcome assessors, which may have influenced self-reported acceptability ratings
Small sample size (24 participants, 12 per arm) resulting in imprecise estimates and lack of statistical power for between-arm comparisons
Overall 12-week retention was 67% (16/24), driven largely by non-attendance at the single in-person visit, limiting completeness of exploratory clinical outcome data
Asymmetry in ascertainment of reasons for non-attendance across arms due to lack of interim study contact in the usual care arm

Implication

Supports feasibility of post-ED pharmacist telemonitoring in underserved patients without primary care; leaves open comparative BP efficacy, requiring adequately powered trials (n=24).

Abstract

Objectives To evaluate the feasibility, fidelity and acceptability of a pharmacist-led remote blood pressure monitoring (RBPM) telehealth intervention in an emergency department postdischarge clinic (ED-PDC) and to assess preliminary effects on systolic blood pressure (SBP) over 12 weeks. Design Pilot randomised controlled trial (RCT) with a parallel-group (1:1) design. Setting Academically affiliated ED-PDC in Alabama, USA (July 2024–January 2025). Participants Adults aged ≥18 years with SBP 130–160 mm Hg, English-speaking, smartphone owners and without an established primary care provider. The cohort was predominantly Black (71%), 38% female, with a mean age of 48.4±12.8 years. 24 were randomised (12 per arm). Interventions Participants were randomised to RBPM (Withings BPM Connect Pro) with weekly pharmacist-led telehealth visits or to usual ED-PDC care. Both arms received hypertension education and completed a 12-week in-person follow-up. Primary and secondary outcome measures Primary outcomes were recruitment, 12-week retention and intervention fidelity. Secondary outcomes included acceptability (acceptability of intervention measure (AIM), intervention appropriateness measure (IAM) and feasibility of intervention measure (FIM)). The exploratory clinical outcome was the change in SBP at 12 weeks. Results Of the 27 people screened, 24 were randomised, and 16 (67%) completed the 12-week in-person visit (n=8 in each arm). RBPM participants completed a mean of 10.6±3.3 of 12 planned pharmacist visits. Acceptability was high (AIM 4.69±0.88; IAM 4.75±0.71; FIM 4.78±0.41). Mean SBP decreased from 153.5±15.8 to 128.9±21.0 mm Hg in the RBPM arm (p=0.024) and from 158.1±21.9 to 133.0±21.6 mm Hg in the usual care arm (p=0.003); the between-group difference was 0.5 mm Hg (95% CI −25.7 to 26.7). At 12 weeks, 75% (6/8) of RBPM participants achieved SBP ≤130 mm Hg versus 50% (4/8) in usual care. Conclusions A pharmacist-led RBPM telehealth programme integrated into an ED-PDC is feasible, highly acceptable and associated with meaningful SBP reductions and a higher rate of BP control in the RBPM arm. These promising findings support a fully powered multisite RCT. Trial registration number ClinicalTrials.gov NCT06247111.

Discussion

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Cite This Study

Ghazi et al. (2026) conducted an RCT in Elevated blood pressure / Hypertension (SBP ≥130 mm Hg or DBP ≥80 mm Hg, not exceeding 160/100 mm Hg) (n=24). Remote blood pressure monitoring (Withings BPM Connect Pro) with weekly pharmacist-led telehealth visits vs. Usual emergency department postdischarge clinic (ED-PDC) care with hypertension education was evaluated on Feasibility (recruitment rate, 12-week retention rate, and intervention fidelity) and exploratory change in clinic systolic blood pressure at 12 weeks (MD 0.5 mm Hg, 95% CI -25.7 to 26.7). Pharmacist-led remote BP monitoring achieved 88.9% recruitment, 67% retention, and a 22.4 mm Hg SBP reduction at 12 weeks (between-group MD 0.5 mm Hg, 95% CI -25.7 to 26.7).

synapsesocial.com/papers/6addd9d56263b750f31760d4 https://doi.org/10.1136/bmjopen-2026-121681

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Feasibility and acceptability of a remote blood pressure monitoring pharmacist-led telehealth programme in an emergency department transition care clinic: a pilot randomised controlled trial

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Feasibility and acceptability of a remote blood pressure monitoring pharmacist-led telehealth programme in an emergency department transition care clinic: a pilot randomised controlled trial

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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