Remote monitoring, pharmacy telehealth visits improved BP control among rural patients
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Key takeaways:
- Collaborative telehealth visits and remote monitoring improved BP control and reduced hospitalizations.
- Patients with higher BP had larger improvements vs. those closer to control at baseline.
Remote BP monitoring and collaborative telehealth visits with a pharmacist improved BP control among patients at rural nephrology clinics and reduced hospitalization, a speaker reported.
Alexander Chang, MD, MS, nephrologist and associate professor in the department of nephrology and the department of population health sciences at Geisinger Health in Danville, Pennsylvania, presented the results of a study to evaluate a remote monitoring and telehealth program for BP control at the Hypertension Scientific Sessions.
“In our study, we developed a program that builds off what others have done using telemonitoring and pharmacists,” Chang said in a press release. “By deploying these extra resources to get blood pressure under control in high-risk patients and reducing hospitalizations, we are hoping that we can help provide more justification in expanding these types of programs.”
Chang and colleagues conducted a community-based analysis to determine whether self-measured BP remote patient monitoring program could improve health care utilization and BP control in a largely rural area of Pennsylvania. The study enrolled 205 patients at nephrology clinics in central and northeast Pennsylvania (mean age, 62 years; 48% women; 53% with chronic kidney disease).
The program consisted of a telehealth platform with Bluetooth-connected BP devices. During the first 6 months of the trial, high BP alerts were sent to patients’ nephrologists for management. After 6 months, notifications were sent to pharmacists, who comanaged patients’ BP via collaborative telehealth. Change in self-measured BP over time was assessed, and the main outcomes of interest were all-cause hospitalization and ED visit in the 6 months before and after enrollment.
The researchers reported that self-measured BP control — defined as self-measure BP of less than 140/90 mm Hg — improved from 30% of the cohort during week 1 to 67% and 74% at 6 and 12 months, respectively.
Improvement in self-measured systolic BP at 6 months was larger among patients with baseline BP of 150/100 mm Hg or more compared with patients with BP of 140/90 mm Hg to 149/99 mm Hg at baseline (3.3 mm Hg vs. 2.4 mm Hg reduction per month).
Overall, 65% of patients had a pharmacist telehealth encounter, during which 46% had a BP medication adjustment and 37% had new BP medication classes (9% mineralocorticoid receptor antagonist), according to the study.
In addition, pharmacist telehealth encounters after self-measured BP alerts were associated with a significant decline in systolic BP over time (1.3 mm Hg per month; 95% CI, 1.6 to 1.1); fewer hospitalizations compared with the 6 months before enrollment (6% vs. 0%); Exact Mcnemar P = .0005) and no change in ED visits (14.9% vs. 12.9%; P = .6).
“We know that home blood pressure monitoring can be done by patients accurately and can really help engage patients in their own health,” Chang said in the release. “However, we also know that these self-measured blood pressure readings often do not make it back to patients’ health care team, therefore, delays in adjusting medications are very common. This type of physician-pharmacist collaborative model with home blood pressure monitoring that is centrally received and monitored by the care team can help address these issues.”
Reference:
- Remote monitoring and pharmacist helped improve hard-to-control blood pressure. https://newsroom.heart.org/news/remote-monitoring-and-pharmacist-helped-improve-hard-to-control-blood-pressure. Published Sept. 5, 2024. Accessed Sept. 16, 2024.
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Bitton N, et al. Abstract MP11. Presented at: Hypertension Scientific Sessions; Sept. 5-8, 2024; Chicago.
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