Abstract P99: Improving Blood Pressure Control in a Workplace Setting: Evaluation of a Web-Based Self-Monitoring Program for Hypertensive and Prehypertensive Employees

Abstract

INTRODUCTION: Many self-insured companies are exploring innovative programs to improve their workforce health. Hypertension and prehypertension are prevalent and lead to costly consequences for both employer and employee. New technologies allow individuals to play a greater role in self-management of their condition. METHODS: We conducted a cluster randomized clinical trial to explore the effect of a web-based self-monitoring program on blood pressure (BP) control of employees with hypertension and prehypertension. A total of 404 subjects across 6 EMC worksites in Massachusetts were randomized at the site level to intervention or control group. Intervention subjects received a BP monitor linked to a communication device that uploaded BP readings to a secure website. The website enabled intervention subjects to track BP readings over time, access tailored feedback and educational material, and prompted them to see a doctor if readings became, or remained, out of control. Control subjects had access to a BP monitor at the worksite. All subjects were monitored for 6 months. RESULTS: Overall, 56.9% (107/188) and 55.3% (104/188) of intervention subjects showed an improvement in systolic (SBP) and diastolic blood pressure (DBP) respectively, compared to 49.51% (101/204) and 35.78% (73/204) of controls (p=0.002 and p=0.002 respectively). A decline of >=5 mm Hg in DBP was seen in 28.7% (54/188) of intervention subjects compared to 16.2% (33/204) controls (p=0.03). Similarly, 22.3% (42/188) of intervention subjects achieved a >= 10 mm Hg decline in SBP compared to 16.7% (34/204) of controls (p=0.02). In addition, 63.4% (111/175) of intervention subjects reported improved communication with their doctor as a result of participation, compared to 51.1% (97/190) of controls (p=0.02); and 22.2% (26/117) of intervention subjects started a new BP medication as a result of participation, compared to 10.9% (12/110) of control subjects (p=0.03). Findings remained significant after adjusting for demographics, lifestyle factors etc. CONCLUSION: This study demonstrates the efficacy of a web-based BP self-monitoring program at improving employee BP control. Use of the program appears to promote discussions about BP management between patients and their physicians.