Home-based blood pressure monitoring using the AHOMKA care model: a longitudinal single-group pilot study in Accra.

Abstract

Background: Hypertension is a major risk factor for cardiovascular disease and requires long-term health treatment and ongoing monitoring to the extent that traditional management approaches may be limited in providing. Adopting appropriate digital tools like mobile health technology (mHealth) could be an effective strategy for improving the control and management of this public health burden. This pilot study evaluated the feasibility of the AHOMKA care model at two tertiary hospitals in Ghana. Outcome measures were changes in systolic (SBP) and diastolic (DBP) blood pressure model acceptance by patients and health care providers.

Objective: This study sought to assess the overall pattern of home blood pressure self-monitoring among participants from two teaching hospitals in southern Ghana, using mHealth.

Methods: Participants attending two (2) cardiology clinics were recruited for this mixed-method pilot study over a period of eight (8) weeks. Following a longitudinal single-group approach, we conducted structured interviews at the baseline and endline and used exports of the AHOMKA mHealth application, in-depth interviews and focus group discussions with patients and healthcare providers. Repeated measures analysis of variance was adopted to assess differences in SBP and DBP between baseline and end line.

Results: This pilot study involved 27 participants with a mean of 50.4 ± 11.0 years-approximately 1:1 male-female participation. Mean SBP decreased by 11.6 mm Hg (95% CI = 15.0 to -8.2), from an average of 138.6 mmHg at baseline to 126.2 mmHg at endline. Average DBP was also significantly reduced by 3.0 mmHg (95% CI = -5.5 to -0.5), from an average of 87.0 mmHg at baseline to 83.0 mmHg at endline. Patients and healthcare providers were satisfied and optimistic about the AHOMKA care model.

Conclusion: The encouraging trend in BP outcomes and high response rate from this pilot study provides evidence for further investigation involving the assessment of the effectiveness of the AHOMKA care model while culturally adapting the model to the Ghanaian context. In the spectrum of hypertension interventions, AHOMKA has the potential to ease the burden on the public health system.