A3824 Effectiveness of Home Blood Pressure Telemonitoring

Abstract

Objectives: To summarize evidence about the effectiveness of home blood pressure telemonitoring (HBPT) and identify the key components of intervention. Methods: We comprehensively searched PubMed, EMBASE and the Cochrane Library for relevant studies. The authors were contacted for additional information. Two authors independently extracted the data and assessed the risk of bias. Results: 46 randomized controlled trials (RCTs) including a total of 13 875 cases were identified. Compared to usual care, HBPT improved office systolic blood pressure (BP) and diastolic BP by 3.99 mmHg (95% CI: 5.06 to 2.93; p < 0.001) and 1.99 mmHg (95% CI: −2.60 to −1.39; p < 0.001), respectively. A larger proportion of patients achieved BP normalization in the intervention group (RR: 1.16; 95% CI: 1.08 to 1.25; p < 0.001). For HBPT plus additional support (including counseling, education, behavioral management, medication management with decision, adherence contracts, etc.) versus HBPT alone (or plus less intense additional support), the mean changes in systolic and diastolic BP were 2.44 mm Hg (95%Cl, 4.88 to 0.00 mm Hg; p = 0.05) and 1.12 mm Hg (95% CI, −2.34 to 0.1 mm Hg; p = 0.07), respectively. For those surrogate outcomes, low strength evidence failed to show difference. In subgroup analysis, high strength evidence supported a lower BP with HBPT that lasted for 6 or 12 months and was accompanied with counseling support from study personnel. Conclusion: HBPT can improve BP control in the hypertensive patients. It may be more efficacious when a proactive additional support is provided during the intervention process.