Abstract 091: Efficacy Of A Patient-engagement Platform In Reducing Uncontrolled Hypertension In Community Health Clinics

Abstract

Introduction: Hypertension affects 47% of US adults and can lead to serious sequelae such as myocardial infarction and stroke when uncontrolled. Over 37 million US adults have blood pressure (BP) higher than 140/90 mmHg. Medication to treat hypertension is effective, yet, approximately 50% of patients do not take medication as prescribed and non-adherence to cardioprotective medications increases a patient’s risk of death from 50% to 80%. Objective: To use a novel patient engagement platform to assist federally qualified health centers (FQHCs) in improving BP control. Methods: We enrolled patients treated at FQHCs in a digital hypertension management program. Patients were prompted to submit their BP and responses to questions about medication adherence and potential side effects of medication either daily or weekly in English or Spanish. The responses were prioritized by level of concern. The clinic reviewed these data, in real-time and provided coaching or treatment changes. We analyzed first and last systolic and diastolic BPs of patients who participated for ≥90 days (range 90-721 days) and considered BP <140/90 mmHg to be controlled. Results: The cohort included 2500 patients, 38.6% male, with a mean age of 53.9 years (range 14-100 years) from 43 FQHCs across the US. Of these patients, 30.7% (768 of 2500) had an initial controlled BP and 61.2% (1529 of 2500) demonstrated a final controlled BP measurement. In patients with an initial uncontrolled BP, 55.4% (959 of 1732) had a controlled final BP. The Spanish language version was used by 551 patients, and in this subgroup, 35.2% (194 of 551) and 70.4% (388 of 551) had controlled BPs on initial and final measurements, respectively, with 66.0% (235 of 356) of initially uncontrolled patients having a controlled final BP. Conclusion: This novel hypertension control program, which used technology to gather and prioritize data, facilitating the clinic’s efficient response, improved BP control rates by over 30% in a real-world, underserved population. BP control was higher in the Spanish-speaking population. Remote digital monitoring with intervention improves clinical outcomes without increasing the overall cost of care, thereby promoting value-based care strategies for chronic diseases such as hypertension.