Population Health Approach to Blood Pressure Control Using Advanced Practice Provider-Managed Remote Patient...

Area of Science:

• Cardiology
• Hypertension Management
• Digital Health

Background:

• Home blood pressure (BP) monitoring is recognized as more reliable than in-clinic measurements.
• Current hypertension (HTN) quality metrics predominantly rely on in-clinic BP readings, creating a gap in accurate patient assessment.
• An advanced practice provider (APP)-managed remote patient monitoring (RPM) program was implemented to address these limitations.

Purpose of the Study:

• To evaluate the effectiveness of an APP-managed RPM program in improving blood pressure (BP) documentation and management for patients with hypertension (HTN).
• To assess the impact of RPM on achieving target BP goals and enhancing institutional quality metrics.

Main Methods:

• A retrospective review of electronic health records (EHR) for internal medicine patients with uncontrolled HTN (BP ≥140/90 mm Hg) was conducted.
• Patients were offered RPM with a BP monitor transmitting readings to the EHR, coupled with APP-led follow-up for lifestyle and medication adjustments.
• Target BP goals were individualized, with lower targets (<130/80 mm Hg) for higher-risk patients.

Main Results:

• The program led to significant improvements in average systolic BP (149.8 to 131.3 mm Hg) and diastolic BP (84.0 to 79.3 mm Hg) over 12 months (p < .001).
• The percentage of patients achieving a documented BP <140/90 mm Hg increased by 7.94% in the RPM group, compared to 1.75% in a standard care comparison clinic (p = .022).

Conclusions:

• An APP-managed RPM program effectively improved blood pressure control in patients with hypertension.
• The program demonstrated a significant positive impact on both patient BP outcomes and institutional quality metrics.