Abstract P115: Feasibility Of Implementing A Remote Blood Pressure Monitoring And Management Program
Introduction: Hypertension guidelines recommend remote monitoring of blood pressure (BP) but widespread implementation is lacking due to several multi-level barriers. Hypothesis: Barriers to remote monitoring and management of hypertension are largely surmountable by reorganization of the current model of hypertension management and leveraging new technology, implementation science, and team-based system-wide processes. Methods: We conducted a NIH funded multi-disciplinary pragmatic type 1 hybrid effectiveness implementation pilot study to lower BP in patients ≥65 years old, combining evidence-based strategies and incorporating them in the clinic flow. We used the electronic health record for real time identification of patients with poorly controlled hypertension and approached them for enrollment. Enrolled participants were randomized to either the virtual collaborative care clinic (vCCC) where trained pharmacists monitored and managed BP through telehealth or to usual care with education. All patients were provided with electronic BP cuffs. The entire study was conducted remotely due to the COVID-19 pandemic. We used surveys and interviews to assess feasibility, acceptability, and satisfaction scores. Results: There was a high enrollment rate with 31 of the 93 potentially eligible patients participating in the 12-week feasibility study. Twenty-nine patients have completed the study: 15 in the vCCC and 14 in the usual care group. SBP decline was 13.7 ± 18.6 mmHg in the vCCC group compared to 4.3 ± 20.5 mmHg in the usual care. Additionally, patients in the vCCC group used their home BP monitors more often, with mean usage 6.3 times per week compared to 0.6 times in the usual care group. The vCCC program had high patient, pharmacist, and physician satisfaction scores. Provider acceptability and feasibility was also high. Conclusion: The vCCC program may be an effective strategy to manage hypertension in the future. The program had high acceptability and satisfaction, along with better reduction in SBP. These data support a larger health system wide study using the vCCC for hypertension management.