Improving hypertension control and patient engagement using digital tools

Milani, Richard V., Lavie, Carl J., Bober, Robert M., Milani, Alexander R. and Ventura, Hector O. (2017) Improving hypertension control and patient engagement using digital tools. American Journal of Medicine, 130 1: 14-20. doi:10.1016/j.amjmed.2016.07.029

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Author Milani, Richard V.
Lavie, Carl J.
Bober, Robert M.
Milani, Alexander R.
Ventura, Hector O.
Title Improving hypertension control and patient engagement using digital tools
Journal name American Journal of Medicine   Check publisher's open access policy
ISSN 1555-7162
Publication date 2017-01-01
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.amjmed.2016.07.029
Open Access Status File (Author Post-print)
Volume 130
Issue 1
Start page 14
End page 20
Total pages 7
Place of publication New York, NY, United States
Publisher Elsevier
Language eng
Formatted abstract
Hypertension is present in 30% of the adult US population and is a major contributor to cardiovascular disease. The established office-based approach yields only 50% blood pressure control rates and low levels of patient engagement. Available home technology now provides accurate, reliable data that can be transmitted directly to the electronic medical record. We evaluated blood pressure control in 156 patients with uncontrolled hypertension enrolled into a home-based digital-medicine blood pressure program and compared them with 400 patients (matched to age, sex, body mass index, and blood pressure) in a usual-care group after 90 days. Digital-medicine patients completed questionnaires online, were asked to submit at least one blood pressure reading/week, and received medication management and lifestyle recommendations via a clinical pharmacist and a health coach. Blood pressure units were commercially available that transmitted data directly to the electronic medical record. Digital-medicine patients averaged 4.2 blood pressure readings per week. At 90 days, 71% of digital-medicine vs 31% of usual-care patients had achieved target blood pressure control. Mean decrease in systolic/diastolic blood pressure was 14/5 mm Hg in digital medicine, vs 4/2 mm Hg in usual care (P <. 001). Excess sodium consumption decreased from 32% to 8% in the digital-medicine group (P =. 004). Mean patient activation increased from 41.9 to 44.1 (P = .008), and the percentage of patients with low patient activation decreased from 15% to 6% (P =. 03) in the digital-medicine group. A digital hypertension program is feasible and associated with significant improvement in blood pressure control rates and lifestyle change. Utilization of a virtual health intervention using connected devices improves patient activation and is well accepted by patients.
Keyword Chronic disease
Patient engagement
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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