Digital therapeutic for hypertension improves physician-patient communication and clinical inertia: a survey of physicians who implemented CureApp HT in clinical practice.

Abstract

In the 2019 Guidelines for the Management of Hypertension by the Japanese Society for Hypertension, lifestyle modification is recommended for all individuals except those with normal blood pressure. However, no detailed methods have been established to achieve the target blood pressure and resolve clinical inertia. CureApp HT, a digital therapeutic for hypertension that contributes to blood pressure reduction through lifestyle modification, was approved as software as a medical device for reimbursement by Japanese national health insurance in September 2022. This study aimed to survey physicians who implemented CureApp HT to assess how it changes physician-patient communication and contributes to clinical inertia resolution. A questionnaire survey was conducted at three time points: before the first prescription (first survey), 3 months (second survey), and 6 months (third survey) after the first prescription for physicians who had implemented CureApp HT. The primary outcome was the total score of five items on a Likert scale related to physician-patient communication, and it was analyzed based on the 47 physicians who responded to all three questionnaires. The total score of physician-patient communication significantly improved after 6 months of the introduction of CureApp HT, reflecting that physicians observed positive changes in patients' knowledge and attitudes regarding hypertension treatment. Furthermore, the number of physicians who set a target home blood pressure of 125/75 mmHg for their patients significantly increased. CureApp HT allows physicians to recognize changes in patients' disease knowledge and treatment attitudes, enabling them to set more stringent blood pressure targets and addressing clinical inertia. Physicians who implemented CureApp HT recognized changes in the patients' stages of behavioral change through improvements in patients' knowledge of the disease and their attitudes towards treatment, and by experiencing more effective communication, they set stricter blood pressure targets.