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Improving Patient-Reported Outcomes in Stroke Care using Remote Blood Pressure Monitoring and Telehealth.
Imama A Naqvi1, Kevin Strobino1, Hanlin Li2
1Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States.
Applied Clinical Informatics
|November 8, 2023
Summary
This study shows that telehealth with patient-reported outcomes (PROs) is feasible for underserved stroke survivors, potentially improving well-being and reducing psychological distress. Remote blood pressure monitoring empowers patients in poststroke self-care.
Area of Science:
- Health Informatics
- Cardiovascular Health
- Neurology and Rehabilitation
Background:
- Healthcare access inequities impact medication adherence and blood pressure (BP) control.
- Informatics solutions can promote equitable care and enhance patient self-management.
- Patient-reported outcomes (PROs) are crucial for assessing well-being in poststroke care.
Purpose of the Study:
- To assess the feasibility of integrating PROs into the Telehealth After Stroke Care (TASC) program.
- To explore the impact of team-based remote BP monitoring on psychological distress and quality of life in an underserved urban population.
Main Methods:
- Randomized controlled trial of 50 stroke survivors comparing TASC (BP monitor, tablet for data/surveys) with usual care for 3 months.
- Utilized PROMIS-MMT, PAM, Neuro-QOL (Cognitive, Depression), and PHQ-9 questionnaires.
- Employed t-tests and linear regression to analyze PRO changes between groups.
Main Results:
- The TASC program demonstrated feasibility in collecting PROs via a web-based platform, with various submission methods utilized.
- A nominal decrease in PHQ-9 depressive scores was observed in the TASC group compared to usual care (p=0.06).
- No significant differences were found in PROMIS-MMT, PAM, or Neuro-QoL measures between the groups.
Conclusions:
- Collecting PROs via interactive web platforms is feasible in poststroke care.
- Team-based remote BP monitoring shows a positive effect on patient well-being.
- Empowering patients with resources can help mitigate health outcome inequities after stroke.
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