Fund for Public Health in New York
Southwest Brooklyn, Bronx, Harlem
Hypertension
African American, Latino

Project

Patients transmit blood pressure readings using at-home monitors.

Patients discuss their blood pressure goal, monitoring regimen and action plan with their doctor and receive a blood pressure monitor for use at home. Patients are asked to transmit their readings once a month for nine months, and receive monthly reminders to transmit their data. The blood pressure monitors transmit the readings via modem and phone line to a secure database. The blood pressure readings are also recorded by patients on a tracking card and brought to follow-up visits with their provider. This allows physicians to get a more complete picture of their patient’s health and potentially influence treatment decisions. The intervention is being implemented in three clinic networks.

Rationale

Self-monitoring of blood pressure has shown to be an effective tool for improving hypertension control. This project addresses both patient-and provider-level mechanisms that may lead to reductions in blood pressure and improved hypertension control.

Self-monitoring by patients may allow physicians to titrate medications more accurately, and it may encourage patients to more actively participate in their own health care. Home blood pressure readings have the potential to prompt physicians to advance care by monitoring blood pressure more frequently and therefore having more information to make clinical decisions. This may help overcome ‘clinical inertia,’ in which doctors fail to intensify treatment for patients who need it. At-home blood pressure monitoring may make an asymptomatic condition feel more “real” for patients, stimulating healthy behavior changes.

Summary Results

Patients were asked to self-monitor their blood pressure daily and transmit results monthly to their providers. After 10 months, the percentage of patients in the intervention group with improved systolic blood pressure was comparable to the percentage in controls (38.9% vs 39.1%). This is a feasible intervention.

Publications

Self-Blood Pressure Monitoring in an Urban, Ethnically Diverse Population: A Randomized Clinical Trial Utilizing the Electronic Health Record
Circ Cardiovasc Qual Outcomes. 2015 Mar 3. pii: CIRCOUTCOMES.114.00095046.
Full Article (subscription may be required)

Principal Investigators

• Thomas Farley, MD, MPH (Commissioner, New York City Department of Health and Mental Hygiene)
• Sonia Y. Angell, MD, MPH, DTMH (Director of Cardiovascular Disease Prevention, New York City Department of Health and Mental Hygiene)