Author + information
- Naomi Fisher,
- Liliana Smolinsky,
- Jaclyn Pagliaro,
- Sonali Desai,
- Lina Matta,
- Benjamin Scirica and
- Calum MacRae
Hypertension (HTN) affects 1/3 of adults; uncontrolled, it is a major risk factor for CV disease, stroke and death. Control rates for HTN nationwide are suboptimal at 52%. We describe an innovative blood pressure (BP) management program to improve control utilizing solely telemonitoring and non-physician interventions.
We established a multidisciplinary, remote management program, leveraging patient navigators, PharmD and NP to implement an expert-developed HTN treatment algorithm. Patients with uncontrolled HTN (office BP >140/90 mmHg) were enrolled using EMR review and provided a Bluetooth enabled BP cuff linked to the EMR. Patients recorded their BP twice daily in duplicate (AM/PM); titrations were based on one week of home BP averages. Patients were also counseled on diet, exercise, and weight loss. Home BP goals were <135/85 mmHg and 145/85 mmHg if >80 y/o.
In the first 100 patients enrolled, control was achieved in 87% who completed the program, in an average of 6 weeks. BP fell by an average of 34 mmHg/12 mmHg. 15 patients did not complete due to non-compliance and other reasons. We identified 23% of patients with white coat HTN, sparing them unnecessary medications. 3 patients with resistant HTN were referred to a specialist.
A home based, remote BP program led by navigators, pharmacists and NPs can provide efficient and effective BP optimization. Further iterations in education, IT and asynchronous communication will allow greater scaling and userability.
Moderated Poster Contributions
Prevention Moderated Poster Theater, Poster Hall, Hall A/B
Monday, March 12, 2018, 12:30 p.m.-12:40 p.m.
Session Title: Approaches to Management of Hypertension
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1324M-03
- 2018 American College of Cardiology Foundation