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Home monitoring, pharmacist care improved BP control at 6 months
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Patients with uncontrolled hypertension can effectively reduce their BP at 6 months with home telemonitoring and pharmacist case management, researchers reported at the American Heart Association’s Quality of Care and Outcomes Research 2012 Scientific Sessions.
At 6 months, 71.8% of hypertensive patients assigned to telemonitoring and pharmacist care reduced their BP to the target of ≤140/90 mm Hg and <130/80 mm Hg for those with diabetes and kidney disease. This is compared with 45.2% of hypertensive patients assigned to traditional care through primary care providers (P<.0001 for comparison). Overall, BP decreased more in the telemonitoring group. At baseline, patients’ BPs averaged 148/85 mm Hg. At 6 months, the average was 126/76 mm Hg in the intervention group and 138/82 mm Hg in the traditional care group.
The study included 450 patients (83% white, mean age, 61 years) with uncontrolled hypertension who had their BP measured at baseline; 403 patients had follow-up data at 6 months. The intervention group also saw a primary care provider and received additional hypertension management and telemonitoring support from a pharmacist. These patients measured their BP at home and sent recordings electronically to a secure website. Participating pharmacists assessed the information and consulted patients every 2 to 4 weeks by phone.
After 6 months, patients in the telemonitoring group reported better drug adherence received more antihypertensive therapies vs. patients in the traditional care group (2.3 drugs vs. 1.6 drugs). Thiazide diuretics and ACE inhibitors were the most commonly used drugs, while loop diuretic use decreased.
“This intervention may be cost-effective for managing hypertensive patients with uncontrolled BP, especially if results are sustained during the maintenance and post-intervention phases of follow-up,” Karen L. Margolis, MD, MPH, director of clinical research of HealthPartners Research Foundation in Bloomington, Minn., and colleagues concluded.
The intervention lasts 12 months, with follow-up to 18 months to observe durability, according to the researchers.
For more information:
- Margolis KL. Presentation #7. Presented at: the American Heart Association’s Quality of Care and Outcomes Research 2012 Scientific Sessions; May 9-11, 2012; Atlanta.
Disclosure: The researchers report no relevant financial disclosures.