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Published on: April 19, 2019
Hypertension Control and Medication Titration Associated With Lifestyle Medicine Virtual Group Visits and Home Blood
Jacob B Mirsky1, Tiffany X V Bui1, Connor B Grady1
1Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA (JBM); Harvard Medical School, Boston, MA, USA (JBM, AB); Center for Innovation in Digital HealthCare, Massachusetts General Hospital, Boston, MA, USA (TXVB); Department of Biostatistics, Informatics, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (CBG); and Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA (JAP, AB).
Abstract:
Less than a quarter of the 116 million adults with hypertension in the United States have blood pressure (BP) lower than the guideline-recommended goal of 130/80 mmHg. There is a critical need for novel interventions that integrate evidence-based recommendations-such as lifestyle medicine and home BP monitoring (HBPM)-into clinical care. In this study, we tested the hypothesis that a four-part, primary care physician-led Virtual Group Visit (VGV) series combining lifestyle medicine, Health and Wellness Coaching (HWC), and HBPM could lead to a reduction in BP and antihypertensive medications. There was a decrease in systolic (β = -.108 mmHg per day; P = .046) and diastolic (β = -.058 mmHg per day; P = .026) BP. Thirteen of the 22 patients (59%) who started the VGV series on medications had at least one medication dosage reduced or discontinued during the VGV series, and 8 of the 18 patients (44%) who finished the VGV series on medications had at least one medication dosage reduced or discontinued in the 180 days after the VGV series. This pilot study demonstrates for the first time that lifestyle medicine VGVs, coupled with HWC and HBPM, are associated with improved BP control and medication deprescribing.
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