Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 4, 2023
Date Accepted: Jun 10, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Efficacy of Web-based Home Blood Pressure Management in Improving Pre-dialysis Blood Pressure Control and Patient Outcomes: Randomized Controlled Trial
ABSTRACT
Background:
Background:
Hypertension is highly prevalent among patients receiving hemodialysis, with a significant proportion experiencing poorly controlled blood pressure (BP). Digital BP management in this population has been underutilized.
Objective:
Objective:
This study aimed to explore the efficacy of a Web-based Home Blood Pressure Monitoring (HBPM) program to improve pre-dialysis BP control and knowledge, perceptions and adherence to HBPM among patients undergoing hypertensive hemodialysis.
Methods:
Methods:
A multicenter, open-label, single-arm, randomized, controlled trial was conducted at two hemodialysis units. Patients were randomly allocated to either the Web-based HBPM program as the intervention group or usual care as the control group over six months. The primary outcome was the control rate for BP before dialysis, assessed from baseline to the six-month follow-up. Secondary outcomes included patient knowledge, perception, and adherence to HBPM, evaluated using the Home Blood Pressure Monitoring Knowledge Questionnaire (HBPKQ), Home Blood Pressure Monitoring Perception Scale (HBPMPS), and Home Blood Pressure Monitoring Adherence Scale (HBPMAS), respectively. The generalized estimating equations analysis was utilized to analyze the outcomes in the intention-to-treat analysis.
Results:
Results:
Of the 165 patients enrolled in the program (n=84, intervention group; n=81, control group), 145 completed the follow-up assessment. The Web-based HBPM group demonstrated a significant improvement in the pre-dialysis BP control rate (OR=5.11, 95%CI 2.14–12.23) after the six-month intervention compared to the control group. Scores on HBPKQ (β=14.43, 95%CI 11.36–17.49), HBPMPS (β=22.51, 95%CI 18.39–26.62), and HBPMAS (β=8.87, 95% CI 6.71–11.03) were significantly higher after six months of intervention.
Conclusions:
Conclusions:
Implementation of a Web-based HBPM program can enhance pre-dialysis BP control, and the knowledge, perception, and adherence to HBPM among patients undergoing hemodialysis. This Web-based HBPM program should be promoted in appropriate clinical settings. Clinical Trial: Trial Registration: China Clinical Trial Registration Center ChiCTR2100051535; https://www.chictr.org.cn/showproj.html?proj=133286.
Citation
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