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Effectiveness of a CDSS and Internet of Things-based comprehensive hypertension management system in primary health
Bingjie Li1,2, Ke Peng1, Ke Xu1,3
1National Clinical Research Center for Cardiovascular Diseases, Heart Failure Ward, Fuwai Hospital Chinese Academy of Medical Sciences, No. 12 Langshan Road, Nanshan District, Shenzhen, Guangdong Province, 518057, People's Republic of China.
Insights
This study introduces the CATCH system, combining a clinical decision support system (CDSS) and Internet of Things (IoT) technology to improve hypertension management in primary care settings. The trial aims to enhance blood pressure control rates through standardized diagnosis, treatment, and continuous patient monitoring.
Area of Science:
- Cardiology
- Public Health
- Health Informatics
Background:
- Cardiovascular and cerebrovascular diseases are leading causes of death in China, with hypertension as a key risk factor.
- Low blood pressure control rates are attributed to limited primary care capacity and poor patient self-management.
- A novel approach is needed to standardize hypertension diagnosis, monitoring, treatment, and management.
Purpose of the Study:
- To evaluate the effectiveness of the CATCH system in improving hypertension management in primary care.
- To provide decision support for primary care clinicians in diagnosing and treating hypertension.
- To enhance the standardization of hypertension care through technology integration.
Main Methods:
- A stepped wedge cluster randomized controlled trial involving 12 community health centers.
- Participants with elevated blood pressure (systolic ≥140 mmHg or diastolic ≥90 mmHg) were enrolled.
- The intervention involved the CATCH system, including a decision-making module, education, and quality control.
Main Results:
- The CATCH trial utilizes CDSS and IoT for improved primary care hypertension management.
- The stepped wedge design facilitates guideline adherence and patient outcome improvement via remote monitoring.
- Equitable intervention access is ensured as all centers receive the CATCH system.
Conclusions:
- The CATCH trial demonstrates the potential of integrated CDSS and IoT for hypertension management.
- Remote monitoring and quality control enhance patient outcomes and adherence to guidelines.
- Findings will inform future strategies for hypertension control in primary care settings.
Background:
Cardiovascular and cerebrovascular diseases are the leading causes of death in the Chinese population, and hypertension is one of the key risk factors. However, the blood pressure control rate of hypertensive patients is low at present. The main factors include the limited capacity of primary care workers and poor self-management among hypertensives. The purpose of this program is to use a clinical decision support system (CDSS) and an Internet of Things-based comprehensive hypertension management system (CATCH) to provide decision support for the diagnosis and treatment of hypertension for primary care clinicians and to improve the standardisation of the diagnosis, monitoring, treatment, and continuous management of hypertension among them.
Methods:
This study is a stepped wedge cluster randomised controlled trial conducted in 12 community health centres in the Third People's Hospital of Longgang District, Shenzhen City, China. All participants who are registered in the community and with systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg at the screening clinic will be asked to participate in the study. The intervention is a CATCH composite of a hypertension auxiliary decision-making module, clinical diagnosis and treatment knowledge education system, and quality control system. All 12 clusters will be divided into 4 clusters and 5 stages according to a randomised method, with each stage lasting 3 months, ensuring that the entire trial will be completed within 12 months.
Discussion:
The CATCH trial uses CDSS and IoT to improve hypertension management in primary care. This stepped wedge trial enhances guideline adherence and patient outcomes through remote monitoring and quality control. All centres receive the intervention, ensuring equitable access to it. Results will guide future hypertension strategies.
Trial Registration:
The trial was registered at the National Medical Research Registration and Record Filing Information System of China in December 2024, was retrospectively registered at the Chinese Clinical Trial Registry (ChiCTR) (Registration number: ChiCTR2500098845) https://www.chictr.org.cn/.
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