An interactive care plan plus remote blood pressure monitoring in a rural primary care clinic: a pilot study.

Abstract

Background: Remote blood pressure monitoring (RBPM), an effective method of enhancing BP control for patients with hypertension, can potentially helpovercome geographic limitations of health care services. We conducted a 90-day pilot to explore combining an interactive care plan (ICP) with RBPM.

Method: The pilot invited fifty adult patients with uncontrolled hypertension (BP ≥140/90 mm Hg) empanelled to a rural primary care practice in midwestern United States. Participants received instructions for downloading an ICP app and were given a wireless BP monitoring device that automatically transmitted readings to their care team. Patients were surveyed after 30 and 90 days about program experience.

Results: Thirty-six patients enrolled. Mean participant age was 59.1 years; most were male, married, and White. Mean baseline BP was 153/89 mm Hg. Participants who engaged in the program for at least 75 days (n = 15) had a postintervention mean BP of 135/80 mm Hg. Sixteen participants (44%) had 1 outpatient visit (no multiple outpatient visits): only 4 (11%) had an emergency department visit. Among survey respondents, most strongly agreed or agreed that 1) ICP app was easy to use, 2) BP device was helpful in home care, 3) interacting remotely with care team was smooth, and 4) they were satisfied with functionality of the RBPM device.

Conclusion: An ICP paired with an RBPM device is a reasonable intervention for managing hypertension in a primary care practice particularly for patients in rural areas. New strategies must be developed to reduce barriers to meaningful engagement, achieve sustainability, and ensure successful widespread adoption.