Abstract 12895: Blood Pressure Outcomes After 9 Months With Remote Patient Monitoring For Hypertension in Primary Care: A Prospective Cohort Study in Electronic Health Records Using Propensity Score Matching

Abstract

Introduction: Remote patient monitoring (RPM) for blood pressure (BP) in primary care may support hypertension control. Hypothesis: Among Medicare patients enrolled from six pilot primary care clinics, those prescribed RPM would have better BP control (BP <140/90 mm Hg), and lower office SBP at 3, 6 and 9 months compared with matched controls. Methods: This was a pragmatic observational study. Patients were included if they belonged to any of six primary care practices that were in pilot studies of the Omron VitalSight TM RPM system which enabled transmission of BP and pulse from a BP monitor into the electronic health record without manual entry. We used 1:4 propensity score matching to identify contemporary matches for 288 RPM-prescribed patients from the same clinics, based on age, sex, systolic BP (SBP), marital status, and several other clinical and healthcare use characteristics. Outcomes included controlling high blood pressure (most recent primary care office or RPM BP <140/90 mm Hg), most recent primary care office SBP, and most recent primary care or RPM SBP, and were assessed after 3, 6, and 9 months. Results: Baseline characteristics of the 288 RPM patients and 1152 controls were similar. The mean ages (SD) were 73.6 (7.4) and 73.8 (7.9) years, respectively. Corresponding mean (SD) SBPs were 142.7 (19.5) and 141.2 (18.7) mm Hg. Controlling high blood pressure was greater in the RPM-prescribed cohort than in matched controls at 3, 6 and 9 months (Table). Mean of last office SBPs did not differ. Means of most recent SBP that included remote values were lower for the RPM-prescribed cohort at 3, 6 and 9 months. Conclusions: BP control and mean of last office or remote SBP diverged quickly and were partially sustained at 9 months. As mean office SBPs did not differ, additional evaluation is needed to assess the degree to which observed differences were due to greater declines in BP overall among RPM patients vs. differences between measured home and office blood pressures.