JMIR Publications

ABSTRACT

Background:

Remote patient monitoring (RPM) is recommended for hypertension control.

Objective:

This study sought to evaluate the association between frequency of blood pressure monitoring and nurse monitoring with hypertension control within three months.

Methods:

This retrospective cohort study was conducted among 1,464 patients with hypertension enrolled in the Brook RPM between 2021 and 2023. Patients with at least three blood pressure measures for 70% of weeks in the program had adequate readings. Brook nurses monitored patients of certain clinics. Hypertension control was defined as weekly average blood pressure less than 140/90 mm Hg. Generalized linear models with a binomial specification and log link were used to estimate the prevalence ratio (PR) and 95% confidence interval (CI) of the mutually adjusted associations between adequate blood pressure readings and Brook nurse monitoring with hypertension control at 4, 8, and 12 weeks, adjusted for patient age and gender.

Results:

The median (25th, 75th percentile) age of patients was 71 (64, 78) years, 53% were female, and 85% were enrolled in Medicare. At weeks 4, 8, and 12, patients with adequate readings had 10% (PR =1.10 95% CI 1.02, 1.20), 12% (PR =1.12 95% CI 1.04, 1.20), and 15% (PR =1.15 95% CI 1.07, 1.24) higher prevalence of hypertension control compared to patients with lower frequencies of readings, respectively. Brook nurse monitoring was associated with 16% (PR =1.16 95% CI 1.07, 1.27), 6% (PR =1.06 95% CI 0.99, 1.15), and 8% (PR =1.08 95% CI 1.00, 1.16) higher prevalence of hypertension control at weeks 4, 8, and 12, respectively, compared to patients who were monitored by clinical staff.

Conclusions:

Our study findings suggest that both frequency of monitoring and specialized nurse monitoring both improve hypertension control in a short time period.