JMIR Publications

ABSTRACT

Background:

Effective blood pressure (BP) monitoring is vital for the management of hypertension, allowing for timely adjustments in treatment. This study focuses on the development and implementation of an innovative, locally-designed eHealth technology, the HeartCare@Home system, to enhance the control and management of hypertension in outpatient non-communicable disease (NCD) clinics in Rwanda. The HeartCare@Home system comprises a mobile health (mHealth) application incorporating rapid-SMS technology, an integrated dashboard for signal reception at Clinic Office level and a clinical decision support (CDS) algorithm.

Methods:

This piloting study will use an interventional design with cross-over approach to test the clinical efficacy of the HeartCare@Home system at the NCD clinic of Kibagabaga district hospital. A total of 140 hypertensive patients will take part in the study. All enrolled patients will be randomized to go either in the interventional group or in standard of care group. The follow up for each group will be 6 months (3 months in each group follow up). The data for the intervention group will be generated by our mHealth application while data for the control group (standard care) will be retrieved from usual patient files at the NCD clinic. Data extraction sheets will be used for standard care data retrieval. The “feasibility of Intervention Measure (FIM)” and “Acceptability of Intervention Measure (AIM)” tools will be used to evaluate cross-sectionally the feasibility and acceptability of the HeartCare@Home system. Data will be summarized with descriptive statistics. A paired sample t-test will be used to test for differences between the pre post intervention records review data for hypertension control. Discussion: This innovative eHealth technology providing home-based BP monitoring data, will offer the unique technology to enable elevated BP control and timely hypertension management in Rwanda and will also ensure a real-time communication linkage between patients and the appropriate level of care. This combined approach will address an important gap of low-rate blood pressure (BP) control in hypertensive patients which were resulting in late consultations and increased cardiovascular mortality. Such eHealth technology infrastructure may also be scalable to other settings.