Abstract P009: Feasibility And Acceptability Of A Digitally-Based Blood Pressure Self-monitoring Program That Promotes Hypertension Self-management And Health Education Among Low-income Patients.

Abstract

Introduction: According to evidence-based clinical guidelines, adults with hypertension should self-monitor their blood pressure regularly. We developed a remote patient monitoring (RPM) program that supports self-monitoring and promotes improved self-management among low-income patients. Hypothesis: We hypothesized that the program would have high feasibility and acceptability among patients with varying digital health literacy and at least 50% of patients would utilize their monitor at a rate required for reimbursement of the cost of the device (16 days of measurements in any 30-day period). Methods: Between 01/2022 and 05/2022, we deployed cellularly connected monitors to patients with hypertension at Family Health Centers of San Diego. Program elements included training on measurement, behavior change, SMS reminders, and physician communication. Data was monitored via a RPM platform provided by Withings. Participants completed a baseline and follow-up survey on digital health literacy and usability. We used descriptive statistics to quantify the utilization of the monitors over time and evaluate usability. Results: Patients who received blood pressure monitors (N=177) had a mean (SD) age of 55 (12.0) years and 57.6% (102 out of 177) were female. Most patients were Hispanic (71.8%, 127 out 177), spoke Spanish (62.7%, 111 out 177), and owned a smartphone (79.7%, 141 out 177). However, only 63.3% (112 out 177) had access to internet or Wi-Fi at home. The mean (SD) SBP was 136.45 mm Hg (20.5) and the mean (SD) DBP was 83.85 mm Hg (13.9). Only 20.9% (37 out of 177) of patients were able to comply with the measurement rate that would result in device cost reimbursement. This did not differ by levels of digital health literacy; with 86.2% (50 out of 58) participants having said they would recommend the monitor to others and 74.1% (43 out of 58) having said they would like to continue using the monitor in the future. Conclusion: Providing a simple and low-cost method to monitor blood pressure was feasible and acceptable to patients. However, relatively few patients were able to use the monitors at a rate that would result in device cost reimbursement. While RPM programs show promise, plans for sustaining costs among low-income patients need to be further evaluated.