Abstract
Objective: Studies exploring wireless-based systems to monitor patients in underinsured communities are lacking. We evaluated blood pressure (BP) control with wireless vs. conventional home-based BP machines in a pilot study nested within a larger trial in San Diego County focusing on optimizing cardiovascular risk reduction. Methods: Patients with a new diagnosis of hypertension (HTN), or those with BP above 140/90 on a current regimen were enrolled from three federally qualified healthcare center systems in low-income communities. Participants were randomized to conventional automated BP cuff (CBP) or a wireless cloud-based system (WBP), and followed with a clinical visit at 3, and 6 months. Exit surveys were conducted to evaluate patterns of use. Results: At the time of this analysis complete clinical data are available for 151 participants (71 WBP; 80 CBP). Baseline BPs did not differ between treatment arms (systolic: 149.9 mmHg WBP; 151 mmHg CBP; P=0.72; diastolic: 83.5mmHg WBP; 81.3 CBP; P=0.23). BP decreased significantly in both arms by the end of the pilot (Figure 1). No differences were seen between groups for both net change of BP (P=0.79) or for end mean systolic BP (P=0.96). Of 60 participants in WBP arm who completed the exit survey, those with BP still not at goal (N=20) were more likely to report “Strongly Agree” or “Agree” that the wireless system helped them feel more engaged in their clinical care (P=0.02). Discussion: Both wireless and conventional BP monitoring had a clinically significant impact on BP control among underinsured individuals in this study, and the wireless system appears to improve engagement in care.
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