Adherence to Telemonitoring Therapy for Medicaid Patients With Hypertension: Case Study

Area of Science:

• Cardiovascular disease research
• Health informatics
• Patient adherence studies

Background:

• Hypertension affects nearly 50% of US adults.
• Home blood pressure monitoring shows promise but faces patient adherence challenges.
• Effective hypertension management requires consistent patient engagement.

Purpose of the Study:

• Characterize Medicaid patient adherence to hypertension telemonitoring.
• Evaluate the impact of adherence reminder calls.
• Investigate the association between adherence and blood pressure control.

Main Methods:

• Analysis of 180-day telemonitoring data from 823 Texas Medicaid patients (2016-2018).
• Exclusion of initial 30-day data; daily readings required.
• Adherence defined as ≥80% daily transmission; reminder calls used for non-adherence.

Main Results:

• Adherent cohort (57.7%) showed improved transmission rates after reminder calls (74.9% to 91.3%).
• Non-adherent cohort (42.3%) also improved (39% to 58%), but less significantly.
• Adherent group experienced significant systolic (2.2 mmHg) and diastolic (0.7 mmHg) blood pressure reduction.

Conclusions:

• High adherence is achievable, but challenges persist.
• Reminder calls improve telemonitoring adherence but may not be sufficient alone.
• Telemonitoring effectively lowers blood pressure, with control positively linked to adherence.