Evaluation of Real-World Patient Engagement in a Remote Patient Monitoring for Hypertension Program.

BACKGROUND

Remote patient monitoring (RPM) for hypertension is effective for lowering blood pressure (BP), but it is unknown whether engagement in RPM is equal for diverse populations or whether engagement impacts achievement of BP targets.

OBJECTIVE

To determine how participant characteristics are associated with level of RPM engagement and examine whether RPM engagement impacts achievement of BP < 140/90 mmHg at six months.

DESIGN

Retrospective cohort study from January 1, 2022 to August 31, 2023.

PARTICIPANTS

Adults with hypertension, referred to RPM by their primary care clinician with the opportunity to be enrolled for least six months of enrollment at an urban academic health center.

MAIN MEASURES: The primary outcome was a high level of engagement, defined as measuring BP more than half the days of the month for at least two of the three first months of participation, versus a low level of engagement. The secondary outcome was BP control < 140/90 mmHg by six months.

KEY

RESULTS

A total of 835 patients were enrolled in RPM. There were 521 (62.40%) participants with a high level of engagement. Older age (aOR = 1.03, 95% CI [1.01, 1.04]) and lower baseline average systolic BP (aOR = 0.98, 95% CI [0.97, 0.99]) were associated with increased odds of a high level of engagement. Gender, race/ethnicity, and preferred language were not associated with level of engagement. Among all participants, 478 (62.65%) achieved BP control by six months. Those with a high level of engagement, adjusted for age, gender, race/ethnicity, and baseline average systolic BP, had 83% higher odds of achieving BP control compared to those with a low level of engagement (aOR = 1.83, 95% CI [1.24, 2.69]).

CONCLUSIONS

RPM engagement was feasible in a diverse patient population and was similar across demographic groups. A higher level of engagement was associated with achieving BP control.