Remote online support for blood pressure control at home is effective and low cost

Home blood pressure monitoring using a web-based system that provides personalized support and is linked to telemedicine professionals is more than face-to-face consultation, according to a study led by researchers at the University of Oxford, Bristol, and Southern Pton. It can lead to excellent hypertension management.

Over 30% of adults grew up in the UK blood Pressure, also known internationally as hypertension, is a major risk factor for cardiovascular disease.Clinical monitoring of hypertensive patients using face-to-face consultation is now a practice for general practitioners, who require many patients to choose virtual consultations to avoid exposure to coronavirus infection. Primary care..

A home and online management and evaluation (HOME BP) randomized controlled trial of blood pressure evaluated a combination of regular self-monitoring. House Use web-based tools that provide reminders, pre-determined drug changes, lifestyle advice, and motivational support.

In their treatise today, BMJ, Researchers, for participants who manage blood pressure at home Systolic blood pressure It was significantly lower after 12 months compared to the one managed exclusively at the clinic, with an average difference of -3.4 mmHg between groups. Those who are self-monitoring at home are also more likely to have their treatment coordinated by a healthcare professional. This approach was not expensive and was £ 11 for every 1 mmHg drop in blood pressure.

622 participants over the age of 18 with hypertension were hired from 76 general practice sessions across the UK, half assigned to home blood pressure control. This study was funded by the National Institute of Health.

Professor Richard McManus, GP and Primary Care Professor at Nuffield College of Primary Care and Health Sciences, Oxford University, said: “When patients self-monitor and manage their blood pressure, these systems often rely on relatively expensive techniques, complex instructions, and / or time-consuming training. And combined with an easy-to-use and inexpensive digital tool that provides patient feedback. Our trials show that this can lower blood pressure at a lower additional cost compared to regular face-to-face care. It was.

“Unfortunately, when many cannot visit their GP directly, this digital and remote approach provides an easy way for the GP to effectively manage hypertension in many members of the community. You can reduce the need to go to the clinic for regular checks. -UPS. ”

Lucy Yardley, a professor of psychology at the University of Bristol and the Faculty of Psychology at the University of Southampton, said: Remote and quality care for hypertensive patients. The HOMEBP trial was developed with extensive feedback from hypertensive patients and primary care staff to ensure that patients and clinicians consider it useful and reliable. ”

Professor Paul Little, a professor of primary care research at the University of Southampton School of Medicine, said: “Given the results of the study, a 10 to 15 percent reduction in patients is expected when this approach is implemented on a large scale. A 5 to 10 percent reduction in patients experiencing stroke and coronary events. Low. At marginal costs, this can make a big difference to millions of people being treated for hypertension in the UK and around the world. ”

Cathy Rice, a stroke survivor who contributed to the development of the HOMEBP trial, said: “I was surprised when I first heard the number of people in the UK whose blood pressure was not well controlled. I am very happy to have this project. I work with patients to measure my blood pressure. , Succeeded in lowering blood pressure. ”

The HOME BP system not only allows the patient’s GP to adjust medication based on regular blood pressure measurements, but also provides evidence-based tips on diet and weight loss, exercise, salt and alcohol reduction. Did. One-on-one behavioral support is also available through hands-on nurses and medical assistants.

At least 30-40% of people with hypertension have already checked their blood pressure, but many do not mention this to their GP or nurse. An accurate monitor can be purchased for about £ 20 and has a useful life of about 5 years. This study suggests that current efforts to encourage people to self-monitor may have real benefits for both NHS and people with high blood pressure. pressure..

Studies have found that this digital approach to managing hypertension is generally beneficial, but for participants over the age of 67. blood pressure Compared to regular care, it turned out to be less noticeable than care under the age of 67. This is unexpected and incompatible with similar research in this area. Researchers say more research is needed to understand if this is a real effect.