Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 23, 2021
Date Accepted: Jan 6, 2022
Pilot Results of a Digital Hypertension Self-Management Program Among Adults with Excess Body Weight: Single-Arm Nonrandomized Trial
ABSTRACT
Background:
Home-measured blood pressure (HMBP) in combination with comprehensive medication support and lifestyle change are the mainstays of evidence-based hypertension (HTN) management. To date, the precise components needed for effective HTN self-management programs have yet to be defined, and access to multi-component, targeted support for HTN management that include telemonitoring remain inaccessible and costly.
Objective:
The aim of this study was to evaluate the impact of a digital HTN self-management program on blood pressure (BP) control among adults with excess body weight.
Methods:
A single-arm, nonrandomized trial was performed to evaluate a digital HTN self-management program that combines comprehensive lifestyle counseling with HTN education, guided HMBP, support for taking medications, and led by either a registered nurse (RN) or certified diabetes care and education specialist (CDCES). A sample of 151 participants were recruited using an online research platform (Achievement Studies, Evidation Health Inc). The primary outcome was change in systolic BP from baseline to 3 months, and secondary outcomes included change in diastolic BP and medication adherence.
Results:
Participants’ mean age was 44.0 (SD=9.3) and mean BP was 139/85 mmHg. At follow up, systolic and diastolic BP decreased by 7 mmHg (p < .001, 95% CI [-9.3, -4.7]) and 4.7 mmHg (p < .001, 95% CI [-6.3, -3.2]), respectively. Participants who started with baseline BP at goal, remained at goal. For participants with stage 1 HTN, systolic and diastolic BP decreased by 3.6 mmHg (p=.09, 95% CI [-7.8, 0.6]) and 2.5 mmHg (p=.03, 95% CI [-4.9, -0.3]). Systolic and diastolic BP decreased by 10.3 mmHg (p<.001, 95% CI [-13.4, -7.1]), and 6.5 mmHg (p< .001, 95% CI [-8.6, -4.4]) for participants with stage 2 HTN. Medication adherence significantly improved (p=.02).
Conclusions:
This study provides initial evidence that a digital HTN self-management program improves BP and medication adherence.
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