Hypertension Medication Changes in Patients Prescribed Remote Monitoring.

Area of Science:

• Cardiology
• Primary Care Medicine
• Health Informatics

Background:

• Remote Patient Monitoring (RPM) involves home blood pressure (BP) measurement with data transmitted to electronic health records (EHR).
• RPM is hypothesized to improve the speed, frequency, and appropriateness of antihypertensive medication adjustments.

Purpose of the Study:

• To evaluate the impact of RPM on the timing and frequency of antihypertensive medication changes.
• To assess differential prescribing decisions for patients with white-coat and masked hypertension using RPM.

Main Methods:

• A study involving 288 hypertension patients using RPM and 1152 matched controls across six primary care clinics.
• BP readings and medication data were collected via EHR over 18 months.
• Patients were categorized based on baseline BP control, sustained hypertension, white-coat hypertension, and masked hypertension.

Main Results:

• RPM patients experienced earlier first medication changes (228 days vs. 530 days for controls) and more total changes.
• White-coat hypertension patients on RPM were less likely to have medication increases compared to sustained hypertension patients.
• Masked hypertension patients on RPM were less likely to have medication decreases compared to baseline-controlled patients.

Conclusions:

• RPM facilitates quicker medication adjustments and more frequent changes, even without dedicated staff.
• RPM enables differential prescribing for white-coat and masked hypertension, supporting its use in primary care.
• The study supports the integration of RPM into routine primary care for hypertension management.