Blood pressure outcomes at 12 months in primary care patients prescribed remote physiological monitoring for hypertension: a prospective cohort study
Remote patient monitoring (RPM) for hypertension enables automatic transmission of blood pressure (BP) and pulse into the electronic health record (EHR), but its effectiveness in primary care is unknown. This pragmatic matched cohort study using EHR data compared BP outcomes between individuals pres...
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| Veröffentlicht in: | Journal of human hypertension 2023-12, Vol.37 (12), p.1091-1097 |
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| creator | Petito, Lucia C. Anthony, Lauren Peprah, Yaw Lee, Ji Young Li, Jim Sato, Hironori Persell, Stephen D. |
| description | Remote patient monitoring (RPM) for hypertension enables automatic transmission of blood pressure (BP) and pulse into the electronic health record (EHR), but its effectiveness in primary care is unknown. This pragmatic matched cohort study using EHR data compared BP outcomes between individuals prescribed RPM and temporally-matched controls from six primary care practices. We retrospectively created a cohort of 288 Medicare-enrolled patients prescribed BP RPM (cases) and 1152 propensity score-matched controls (1:4). Matching was based on age, sex, systolic blood pressure (SBP), marital status, and other characteristics. Outcomes at 3, 6, 9 and 12 months were: controlling high BP (most recent BP |
| doi_str_mv | 10.1038/s41371-023-00850-w |
| format | Article |
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p
< 0.001). This difference persisted but decreased over follow-up. After 12 months, the RPM-prescribed cohort had greater BP control (RPM: 71.5%, control: 58.1%,
p
< 0.001) and lower SBP (132.3 versus 136.5 mm Hg,
p
= 0.003) using all measurements, but they did not differ using only office measurements (12 month BP control: 60.8% versus 58.1%,
p
= 0.44; SBP: 135.9 versus 136.5 mm Hg,
p
= 0.91). At 12 months, the most recent BP measurements were more current for RPM-prescribed patients (median [IQR] 8 [0–109] versus 134 [56–239] days). Net increases in antihypertensive medications by 12 months were similar. Implementation of RPM in primary care could inform hypertension management strategies and increase hypertension control. Registration: ClinicalTrials.gov identifier: NCT05562921.</description><identifier>ISSN: 1476-5527</identifier><identifier>ISSN: 0950-9240</identifier><identifier>EISSN: 1476-5527</identifier><identifier>DOI: 10.1038/s41371-023-00850-w</identifier><identifier>PMID: 37479812</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308 ; 692/700/459 ; Aged ; Antihypertensive Agents - pharmacology ; Antihypertensive Agents - therapeutic use ; Antihypertensives ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Cohort analysis ; Cohort Studies ; Electronic health records ; Electronic medical records ; Epidemiology ; Health Administration ; Humans ; Hypertension ; Hypertension - diagnosis ; Hypertension - drug therapy ; Medicare ; Medicine ; Medicine & Public Health ; Monitoring, Physiologic ; Primary care ; Primary Health Care ; Prospective Studies ; Public Health ; Retrospective Studies ; United States - epidemiology</subject><ispartof>Journal of human hypertension, 2023-12, Vol.37 (12), p.1091-1097</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-67351a12a1e3b075e5e7549de1032306c53059509af332f0cf6cdd528477dff43</citedby><cites>FETCH-LOGICAL-c419t-67351a12a1e3b075e5e7549de1032306c53059509af332f0cf6cdd528477dff43</cites><orcidid>0000-0002-7125-9461 ; 0000-0002-0156-1219 ; 0000-0003-2462-1314 ; 0009-0000-8175-7256 ; 0000-0002-6102-0510 ; 0000-0001-7211-9519</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41371-023-00850-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41371-023-00850-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37479812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Petito, Lucia C.</creatorcontrib><creatorcontrib>Anthony, Lauren</creatorcontrib><creatorcontrib>Peprah, Yaw</creatorcontrib><creatorcontrib>Lee, Ji Young</creatorcontrib><creatorcontrib>Li, Jim</creatorcontrib><creatorcontrib>Sato, Hironori</creatorcontrib><creatorcontrib>Persell, Stephen D.</creatorcontrib><title>Blood pressure outcomes at 12 months in primary care patients prescribed remote physiological monitoring for hypertension: a prospective cohort study</title><title>Journal of human hypertension</title><addtitle>J Hum Hypertens</addtitle><addtitle>J Hum Hypertens</addtitle><description>Remote patient monitoring (RPM) for hypertension enables automatic transmission of blood pressure (BP) and pulse into the electronic health record (EHR), but its effectiveness in primary care is unknown. This pragmatic matched cohort study using EHR data compared BP outcomes between individuals prescribed RPM and temporally-matched controls from six primary care practices. We retrospectively created a cohort of 288 Medicare-enrolled patients prescribed BP RPM (cases) and 1152 propensity score-matched controls (1:4). Matching was based on age, sex, systolic blood pressure (SBP), marital status, and other characteristics. Outcomes at 3, 6, 9 and 12 months were: controlling high BP (most recent BP < 140/90 mm Hg), antihypertensive medication intensification, and most recent SBP assessed using: all measurements, and office measurements only. At baseline, RPM-prescribed patients and controls had similar ages and systolic BP. BP control diverged at 3 months (RPM: 72.2%, control: 51%,
p
< 0.001). This difference persisted but decreased over follow-up. After 12 months, the RPM-prescribed cohort had greater BP control (RPM: 71.5%, control: 58.1%,
p
< 0.001) and lower SBP (132.3 versus 136.5 mm Hg,
p
= 0.003) using all measurements, but they did not differ using only office measurements (12 month BP control: 60.8% versus 58.1%,
p
= 0.44; SBP: 135.9 versus 136.5 mm Hg,
p
= 0.91). At 12 months, the most recent BP measurements were more current for RPM-prescribed patients (median [IQR] 8 [0–109] versus 134 [56–239] days). Net increases in antihypertensive medications by 12 months were similar. Implementation of RPM in primary care could inform hypertension management strategies and increase hypertension control. 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This pragmatic matched cohort study using EHR data compared BP outcomes between individuals prescribed RPM and temporally-matched controls from six primary care practices. We retrospectively created a cohort of 288 Medicare-enrolled patients prescribed BP RPM (cases) and 1152 propensity score-matched controls (1:4). Matching was based on age, sex, systolic blood pressure (SBP), marital status, and other characteristics. Outcomes at 3, 6, 9 and 12 months were: controlling high BP (most recent BP < 140/90 mm Hg), antihypertensive medication intensification, and most recent SBP assessed using: all measurements, and office measurements only. At baseline, RPM-prescribed patients and controls had similar ages and systolic BP. BP control diverged at 3 months (RPM: 72.2%, control: 51%,
p
< 0.001). This difference persisted but decreased over follow-up. After 12 months, the RPM-prescribed cohort had greater BP control (RPM: 71.5%, control: 58.1%,
p
< 0.001) and lower SBP (132.3 versus 136.5 mm Hg,
p
= 0.003) using all measurements, but they did not differ using only office measurements (12 month BP control: 60.8% versus 58.1%,
p
= 0.44; SBP: 135.9 versus 136.5 mm Hg,
p
= 0.91). At 12 months, the most recent BP measurements were more current for RPM-prescribed patients (median [IQR] 8 [0–109] versus 134 [56–239] days). Net increases in antihypertensive medications by 12 months were similar. Implementation of RPM in primary care could inform hypertension management strategies and increase hypertension control. Registration: ClinicalTrials.gov identifier: NCT05562921.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>37479812</pmid><doi>10.1038/s41371-023-00850-w</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7125-9461</orcidid><orcidid>https://orcid.org/0000-0002-0156-1219</orcidid><orcidid>https://orcid.org/0000-0003-2462-1314</orcidid><orcidid>https://orcid.org/0009-0000-8175-7256</orcidid><orcidid>https://orcid.org/0000-0002-6102-0510</orcidid><orcidid>https://orcid.org/0000-0001-7211-9519</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of human hypertension, 2023-12, Vol.37 (12), p.1091-1097 |
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| source | MEDLINE; SpringerLink Journals |
| subjects | 692/308 692/700/459 Aged Antihypertensive Agents - pharmacology Antihypertensive Agents - therapeutic use Antihypertensives Blood Pressure Blood Pressure Monitoring, Ambulatory Cohort analysis Cohort Studies Electronic health records Electronic medical records Epidemiology Health Administration Humans Hypertension Hypertension - diagnosis Hypertension - drug therapy Medicare Medicine Medicine & Public Health Monitoring, Physiologic Primary care Primary Health Care Prospective Studies Public Health Retrospective Studies United States - epidemiology |
| title | Blood pressure outcomes at 12 months in primary care patients prescribed remote physiological monitoring for hypertension: a prospective cohort study |
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