Hypertension management has long relied on in-office visits, but with advancements in technology, remote monitoring is becoming an area of interest. This study explores the effectiveness of a bidirectional text monitoring program designed to manage blood pressure (BP) control and medication adherence, with and without the inclusion of social support, in adults with hypertension. Conducted at an academic family medicine practice in Philadelphia, the randomized clinical trial involved 246 adult participants aged 18 to 75 who had previous elevated BP readings and were on maintenance medications. The study analyzed their BP outcomes over a 4-month period, comparing remote monitoring groups to a usual care group.
The study’s design included three groups: remote monitoring of BP and medication adherence (RM), remote monitoring with additional feedback to a social support partner (SS), and a usual care group (UC). Participants in the RM and SS groups received automatic home BP monitors and weekly text messages regarding BP measurements and medication adherence. Additionally, the SS group’s support partners received weekly progress reports. Clinicians were nudged to adjust medications when patients had consistently elevated BP readings.
Study Findings
After 4 months, the results indicated no significant difference in systolic or diastolic BP between the intervention groups (RM and SS) and the usual care group. Specifically, the adjusted mean differences in systolic and diastolic BP for the RM and SS groups compared to the UC group were minimal and statistically insignificant. BP control was achieved in 49% of the RM group, 31% of the SS group, and 40% of the UC group, showing no substantial improvement with the interventions.
Implications for Hypertension Management
Despite the high hopes for remote monitoring and social support to enhance BP management, the study found that these methods did not significantly outperform usual care. This suggests that simply monitoring BP remotely or adding social support may not be sufficient to improve hypertension control. More comprehensive strategies might be needed to remind patients to take their medications and manage their BP effectively.
Key Takeaways
– Remote BP monitoring and social support did not show significant improvements in BP control compared to usual care.
– Weekly text messages and progress reports might not be enough to manage hypertension effectively.
– Future interventions could benefit from focusing on medication adherence and more personalized approaches.
The study underscores the necessity for innovative approaches to hypertension management. While technology and social support offer new avenues, their efficacy in isolation is limited. Further research is needed to explore integrated methods that can address the complexities of hypertension management more effectively.
Original Article: JAMA Netw Open. 2024 Jun 3;7(6):e2413515. doi: 10.1001/jamanetworkopen.2024.13515.
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