Feasibility of a Self-Measured Blood Pressure Monitoring Program to Reduce Uncontrolled Hypertension.

BACKGROUND: Hypertension is a common, serious condition affecting about one-third of adults in the United States. Self-measured blood pressure (SMBP) monitoring, combined with clinical support, is recommended to improve hypertension control and patient outcomes. METHODS: We conducted a retrospective analysis of a SMBP monitoring program that supported recruited patients in using wireless Bluetooth monitors to track their blood pressure at home and gave outpatient practices real-time access to patients' measurements. We analyzed SMBP measurements, practice-user log data, and patient and practice experience evaluations. RESULTS: Project staff recruited 17 outpatient practices and 187 patients. After four weeks, 64% of participants consistently monitored their blood pressure at least three times per week. A majority of patients (79%) reported an increased ability to manage their hypertension. In total, clinicians received 1,849 alerts and documented 409 actions. CONCLUSIONS: This analysis demonstrates the feasibility of combining SMBP with real-time access to home measurements by outpatient practices.

Innovative Use of a Mobile Web Application to Remotely Monitor Nonhospitalized Patients with COVID-19.

Introduction: Most patients with COVID-19 do not require hospitalization but may need close monitoring, which can strain primary care practices. Our objective was to describe the implementation of a mobile web application to monitor COVID-19 signs and symptoms among nonhospitalized primary care patients and to assess the feasibility and acceptability of the application. Study Design: Retrospective analysis of (1) mobile web application data from March through December 2020 and (2) cross-sectional surveys administered in June 2020. Materials and Methods: We enrolled nonhospitalized patients and staff from nine New England primary care practices across 29 sites. Outcomes included feasibility and acceptability of the application as measured by the proportion of texts that resulted in a response, proportion of patients who agreed using the application was easy, and proportion of practice staff who agreed the application reduced outreach burden and that they would recommend use. Results: Five thousand five hundred thirty-two patients used the mobile web application, with 26,466 total responses. Overall, 78% of the daily texts resulted in a response from patients. Most patients agreed that responding to texts was easy (95%) and that they would be willing to participate in other texting programs (78%). Most staff agreed that the program reduced burden of outreach (94%) and that they would recommend use to other practices (100%). Conclusions: Use of a COVID-19 symptom tracking application was feasible and acceptable to patients and primary care practice staff. Outpatient practices should consider use of mobile web applications to monitor nonhospitalized patients with other acute illnesses.