Effect of remote patient monitoring on stage 2 hypertension.

Objectives: Remote patient monitoring (RPM) is increasingly being utilized in clinical practice to reduce blood pressure in patients with hypertension. RPM depends on home readings by patients electronically transmitted to clinicians and includes automated alerts for excessive abnormal readings. Data demonstrating the efficacy of RPM are limited; moreover, no study has specifically addressed patients with stage 2 hypertension. The current study aimed to address this gap.

Study design: Quasi-experimental retrospective cohort study.

Methods: A cohort of community-dwelling Medicare patients in a large outpatient primary care practice was enrolled in an RPM program if they were diagnosed with hypertension. Patients were followed for 1 year. Each patient was also assigned a nurse to function as a care coach, who communicated with the patients monthly and provided at least 20 minutes of care management.

Results: Of the 3403 Medicare beneficiaries who consented to participate, 1594 actively engaged in the program for 1 year. Of these, 652 had stage 2 hypertension (systolic blood pressure [SBP] ≥ 140 mm Hg and/or diastolic BP [DBP] ≥ 90 mm Hg). The initial mean SBP/DBP ratio for those with stage 2 hypertension was 152/85 mm Hg, which decreased to 132/74 mm Hg by month 12. At baseline, 100% of these 652 patients met the criteria for stage 2 hypertension, but by month 12, this percentage decreased to 25%. In the 163 patients who remained in stage 2 hypertension, a notable decrease in BP was also achieved, with the mean BP dropping from 155/87 mm Hg to 146/77 mm Hg (P < .05).

Conclusions: Deployment of an RPM program in Medicare patients with concomitant care coaching was associated with statistically significant reductions in both elevated BP readings and the presence of stage 2 hypertension.