Daily Dose: Efficacy of a Remote Bilingual Program in Reducing Uncontrolled HTN

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on a study presented at the American Heart Association's Hypertension Scientific Sessions 2023 that examined the effects of a digital hypertension (HTN) management program on blood pressure (BP) control.

The study

Researchers enrolled patients treated at 54 Federally Qualified Health Centers (FQHC) in 13 US states. Patients who did not have home BP monitors were provided them. Using a digital phone app, patients submitted their BP readings and responses to questions about medication adherence and potential side effects of medication either daily or weekly in English or Spanish. The responses were prioritized for further action by clinicians by level of concern.

Health care professionals at the clinics reviewed the data via a web-based portal in real-time and provided coaching or treatment changes to participants. Researchers analyzed first and last systolic and diastolic BPs of patients who participated for ≥90 days (range 90-721 days) and considered a BP of <140/90 mmHg to be controlled.

A total of 2500 patients from 43 FQHCs were included in the study.

Findings

Among the cohort, 30.7% (n=768) had controlled BP at enrollment and 61.2% (n=1529) demonstrated a final controlled BP measurement. In patients with an initial uncontrolled BP, 55.4% (959 of 1732) demonstrated a controlled final BP.

The Spanish language version of the app was used by 551 participants, among whom 35.2% (n=194) and 70.4% (n=388) had controlled BPs on initial and final measurements, respectively. Moreover, of Spanish-speaking participants with initial uncontrolled BP measurements, 66% (235 of 356) achieved controlled final BP measurements.

Authors' comment

"We were surprised that more than 50% of participants in the program were able to attain blood pressure control. These results indicate combining the remote digital monitoring capabilities of the app with feedback from clinicians can improve rates of blood pressure control in a real-world, at-risk population, without increasing the overall cost of care. This digital management program has the potential to improve outcomes and decrease rates of uncontrolled blood pressure, leading to fewer heart attacks and strokes."

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