Abstract
In this implementation science study evaluating the feasibility and effectiveness of a remote patient monitoring program for hypertension, we found that most, but not all of patients received the intended program components of clinical pharmacist outreach and medication titration. Despite feasibility challenges, remote-patient monitoring for hypertension was effective at reducing systolic blood pressure by ≥ 5 mmHg in (64%) and 346 (71%) patients by 3 and 6 months of enrollment respectively. Unexpectedly, chi-square and multivariate logistic regressions analysis showed that the clinical pharmacist outreach, was not associated with blood pressure improvement, but that patient engagement and medication titration were associated with blood pressure improvement. These results suggest that other unmeasured behavioral and lifestyle changes may be a large driver of BP improvement and that while RPM-HTN is a worthwhile intervention, it may not require all ancillary components to deliver meaningful results.
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References
Blood AJ, Cannon CP, Gordon WJ, Mailly C, MacLean T, Subramaniam S, et al. Results of a remotely delivered hypertension and lipid program in more than 10,000 patients across a diverse health care network. JAMA Cardiol. 2023;8:12–21. https://doi.org/10.1001/jamacardio.2022.4018.
Petito LC, Anthony L, Peprah Y, Lee JY, Li J, Sato H, et al. Blood pressure outcomes at 12 months in primary care patients prescribed remote physiological monitoring for hypertension: a prospective cohort study. J Hum Hypertens. 2023;37:1091–7. https://doi.org/10.1038/s41371-023-00850-w
Margolis KL, Bergdall AR, Crain AL, JaKa MM, Anderson JP, Solberg LI, et al. Comparing pharmacist-led telehealth care and clinic-based care for uncontrolled high blood pressure: the hyperlink 3 pragmatic cluster-randomized trial. Hypertension. 2022;79:2708–20. https://doi.org/10.1161/HYPERTENSIONAHA.122.19816
Baik D. Team-based care: a concept analysis. Nurs Forum. 2017;52:313–22. https://doi.org/10.1111/nuf.12194
Kulchaitanaroaj P, Brooks JM, Chaiyakunapruk N, Goedken AM, Chrischilles EA, Carter BL. Cost-utility analysis of physician-pharmacist collaborative intervention for treating hypertension compared with usual care. J Hypertens. 2017;35:178–87. https://doi.org/10.1097/HJH.0000000000001126
American Medical Association. The validation of BP measurement devices for clinical accuracy. 2023. https://www.ama-assn.org/delivering-care/hypertension/validation-bp-measurement-devices-clinical-accuracy. Accessed June 10, 2024
American College of Physicians (ACP). https://www.acponline.org/practice-resources/business-resources/telehealth-guidance-and-resources/remote-patient-monitoring-billing-coding-and-regulations-information. Accessed April 4, 2024.
Blood Pressure Lowering Treatment Trialists’ Collaboration. Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis. Lancet. 2021;398:1053–64. https://doi.org/10.1016/S0140-6736(21)01921-8
Margolis KL, Asche SE, Bergdall AR, Dehmer SP, Groen SE, Kadrmas HM, et al. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial. JAMA. 2013;310:46–56. https://doi.org/10.1001/jama.2013.6549
Fisher NDL, Fera LE, Dunning JR, Desai S, Matta L, Liquori V, et al. Development of an entirely remote, non-physician led hypertension management program. Clin Cardiol. 2019;42:285–91. https://doi.org/10.1002/clc.23141
Chu F, Stark A, Telzak A, Rikin S. Patient experience in a remote patient monitoring program for hypertension: a Qualitative Study. Am J Hypertens. 2024;37:861–7. https://doi.org/10.1093/ajh/hpae086
Funding
Health Resources and Services Administration (HRSA): National Hypertension Control Initiative, Albert Einstein College of Medicine, Summer Research Fellowship.
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HS contributed to study design, data extraction, interpreting results, and manuscript writing. AS assisted with study design, manuscript writing, and editing. AM assisted with data extraction and provided feedback on the report. AS, JM, PB, SK, and PS contributed to study design and provided feedback on the report. CZ assisted with data analysis. SR was involved in study design, data analysis, manuscript writing, and editing.
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Shi, H., Stark, A., Maity, A. et al. Assessment of clinical pharmacist outreach and medication titration in remote patient monitoring program for hypertension. J Hum Hypertens 39, 422–424 (2025). https://doi.org/10.1038/s41371-025-01025-5
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DOI: https://doi.org/10.1038/s41371-025-01025-5
