Home Blood Pressure Telemonitoring and Hypertension Management in Kenya: A Feasibility Study (HBPT-K)

To determine the feasibility of home blood pressure telemonitoring (HBPT) in Kenya and explore its effects on blood pressure (BP) regulation, self-reported drug adherence, patient- and healthcare provider satisfaction, and required telemonitoring time investment.

Six-month single-arm interventional feasibility study. Hundred adults with newly diagnosed or known hypertension with an office BP > 140/90 mmHg were provided with a BP machine and were enrolled in an HBPT program. Primary outcome was BP control (% BP < 140/90 mmHg) between baseline and T = 6 months (SPRINT standardized in-office blood pressure measurement). Secondary outcomes included self-reported adherence (MARS-5 scale), patient- and healthcare provider satisfaction (TUQ and MAUQ questionnaires), and efficiency (time spent processing the blood pressure telemonitoring data).

Between March 2024 and January 2025, 100 patients gave informed consent to participate in the study. Eighty-four patients (mean age 54, SD = 14, 73% females) completed the six-month follow-up and were included in the final analysis. Blood pressure control improved from 0% to 72% after six months (P < 0.0001). Median MARS-5 score at baseline was 25 (IQR 25-25) and remained 25 (IQR 25-25) at T = 6 months. Patient satisfaction scores were high with a median mHealth App Usability Questionnaire (MAUQ) score (range 1-7) of 7 (IQR 6.97-7) and a median Telehealth Usability Questionnaire (TUQ) (range 1-7) score of 6.95 (IQR 6.86-7). Patients participated for an average of 9.2 months in the telemonitoring program and required an E-nurse time investment of 51.7 minutes to process BP data.

HBPT is feasible and improved BP control in a rural setting with limited time investments and high patient- and healthcare provider satisfaction rates.

This study is registered with the Pan African Clinical Trial registration (pactr.samrc.ac.za, trial ID: PACTR202408912454189).