Plenary III–03: Adherence to Home Blood Pressure Monitoring in Patients with Uncontrolled Blood Pressure

摘要

>Background/Aims: Home blood pressure monitoring has been advocated as a method for improving blood pressure (BP) control. However, there is little data on patients’ adherence to home BP monitoring. The purpose was to study patient adherence to home BP monitoring and telephone visits with a healthcare provider in a randomized controlled trial.>Methods: The Hyperlink study is a cluster randomized trial in which adult patients with uncontrolled BP are assigned either to the Telemonitoring Intervention (TI) arm or the Usual Care (UC) arm. These preliminary analyses are based on the first 80 participants of a planned enrollment of 450. Patients in the TI arm work with a clinical pharmacist who serves as their case manager and may adjust their treatment according to a protocol. Following one face-to-face meeting, patients and pharmacists meet via phone every 2–4 weeks for a period of 6 months. Patients are instructed to take 2–3 BP readings on 3 mornings and 3 evenings each week, and to transmit the stored BP data to the pharmacist weekly. Adherence is defined as sending = 6 home BP measurements per week. We examined adherence to both telephone visits and the home BP measurement schedule.>Results: Adherence with the telephone visits was excellent with completion of 359/370 (97%; 95% CI 95%–99%) protocol-mandated telephone visits. Adherence to the home BP measurement schedule was also high, with 73/80 (91%; 95% CI 85%–97%) participants sending an average of >6 BP measurements per week. Participants older than 65 showed greater BP measurement schedule adherence than those younger than 65 (100% versus 86%; p=0.04 by Fisher’s exact text). Adherence did not differ significantly by gender, race or employment status.>Conclusion: Despite an intensive visit and measurement schedule, adherence to blood pressure telemonitoring was very high in the study population. We conclude that blood pressure telemonitoring has the potential to improve BP control by conveying reliable blood pressure data to healthcare providers who can then close the feedback loop by making appropriate therapeutic adjustments.