Technology-based screenings and in-person follow-ups reduced patients' risk of having undiagnosed hypertension over a 30-month period by more than 72 percent, according to a study in the Annals of Family Medicine.
Researchers developed three algorithms that pored through electronic health records to identify patients at risk for undiagnosed hypertension. Those with a diagnosis of hypertension, white-coat hypertension, prehypertension or elevated blood pressure previously were excluded.
They identified, however, those with systolic blood pressure of less than or equal to 135 mm Hg, or mean diastolic blood pressure less than or equal to 85 mm Hg among the patients of primary care physicians in 23 practices. Those patients were asked to come in and have a series of readings taken through an automated office blood pressure (AOBP) protocol. Only about one-third of them did.
As part of a 24-month quality improvement initiative, all primary care physicians received monthly lists of patients who continued to be at risk for undiagnosed hypertension. Those patients were asked to come in and remained on the list until their at-risk status had been resolved. When one of the patients came in for any reason, an alert appeared prominently on his or her EHR that an AOBP measurement was needed.
About half of those who underwent the AOBP protocol during the second phase were diagnosed with hypertension.
Hypertension is not the only area where improved monitoring through technology is helping patients. Home blood pressure monitoring is also effective--as well as being cost-effective for insurers, according to researchers including Alejandro Arrieta, of Florida International University in Miami, who are advocating for reimbursement.
Meanwhile, other research found that providers who played a game dealing with blood pressure control were more successful in getting patients to reach their goal than providers who merely read BP management information online.
To learn more:
- read the study