PRACTICES OF HOME BLOOD PRESSURE MEASUREMENT AND E-HEALTH: REAL-LIFE DATA GENERATED BY THE HY-RESULT APP

Abstract

Objective: To evaluate quality of Home Blood Pressure Measurement (HPBM) data generated in real-life circumstances by Hy-Result software, a validated App designed to help patients to: perform HBPM according to a standardized protocol; understand their results; share their readings in a PDF format report. Design and method: We analyzed 19,176 HBPM reports collected in real-life. Each report was generated by patients who self-measured BP (3 morning, 3 evening) for 1 to 7 consecutive days. Reports totaled over 51,000 BP (SBP)/Diastolic (DBP) readings. Data was generated through App used in-home, by patients following a self-management protocol. Reports are grouped according to two criteria: i) whether generated by “PRIMARY care users” (who find the app on internet or following the recommendation of their practitioner) and “TERTIARY patients” using the app per recommendation of ESH hypertension center; ii) whether patients were receiving antihypertensive drugs or not. The patient reported outcomes are saved in a secured database. Results: Mean age of users was 62 years (62.1 (+/- 13.1), and 63 % of reports (12,117) declared receiving hypertension drugs (Tab 1). PRIMARY were younger, less severely hypertensive, were receiving less treatment and suffered from fewer comorbidities (diabetes, stroke, kidney disease) than TERTIARY (Tab 2). HBPM schedule: Tab. 3, show compliance with monitoring schedule. Reports are considered adequate for medical analysis if patients proceed to a minimum of 15 consecutive measurements for at least 3 days. HBPM oscillometric devices: Upper arm cuff devices are declared by 81 % of PRIMARY reports and 93 % of ESH CENTER. Treated patients used more frequently the recommended monitor than untreated. Furthermore, Therapeutic education in the ESH Center promoted better compliance with the measurement schedule and greater use of humeral devices. Conclusions: Through generating 90% of HBPM reports of sufficient quality for medical interpretation in real-life conditions, the Hy-Result app has significant potential for triage in the care pathway of hypertensive patients in primary care settings or in ESH center for hypertension. Out of 19,000 reports, 43% presented PAS and/or PAD > 135/85 and the users were automatically prompted to seek medical advice by the software.