Abstract 18482: Mobile Phone-based Telemonitoring System Improves Blood Pressure Treatment Of Hypertensive Diabetic Patients
Background and Study Hypothesis: Previously we described an inexpensive fully automated mobile phone-based telemonitoring system that improved blood pressure (BP) control by providing immediate feedback and action messages to patients and summary reports of home BP readings and critical alerts to physicians. In the present study, we tested the hypothesis that this system will improve BP treatment compared to home BP monitoring without teletransmission capability.
Methods: Adult diabetic patients with uncontrolled systolic hypertension were randomly assigned to monitor their BP at home in the standard manner (n=55) or using a mobile phone-based telemonitoring system (n=55). All subjects were given a validated home BP measuring device and instructed on its use. Telemonitored subjects also received a pre-programmed mobile phone that automatically and securely transmitted readings from the commercially available Bluetooth-enabled home BP monitor to the application server. Primary care physicians provided medical care for all patients. The primary outcome measure was the mean between-group difference in daytime systolic BP change from baseline to 12-months after randomization recorded by 24-ambulatory BP monitoring. Results are mean ± standard deviation.
Results: The mean age and weight were 62.2 ± 8.2 years and 90.2 ± 24.1 kg respectively; 37.3% were women. Overall, the baseline mean daytime systolic and diastolic BP were 142.7 ± 10.5 and 77.1 ± 9.9 mm Hg, respectively, and there were no between-group differences. At 12 months the within-group change in mean daytime systolic BP was -9.1 ± 15.6 mm Hg in the telemonitored group (n=54; p<0.0001) and -1.6 ± 12.4 mm Hg in the control group (n=49; p=0.37). Mean between-group difference in systolic and diastolic BP changes was 7.5 ± 13.0 (p<0.008) and 3.2 ± 8.1 mm Hg (p<0.05), respectively. BP control, defined as daytime BP <130/80, was significantly higher in the telemonitored group (37.0% v. 14.2%, p<0.02).
Conclusion: A mobile phone-based telemonitoring system, designed to actively engage hypertensive patients in their own care and enhance communication with physicians, significantly improved BP treatment of diabetic patients with uncontrolled systolic hypertension.
- © 2010 by American Heart Association, Inc.