Abstract 4366385: Improving Hypertension Control Rates by Implementing a Self-Monitored Blood Pressure Program

Abstract

Introduction: Hypertension (HTN) is a major contributor to both heart disease and stroke, with a prevalence of 48%. While Black patients have a higher prevalence of HTN than their White counterparts, they also experience lower overall control rates, making them a high-risk group for complications related to HTN. Self-monitored blood pressure (SMBP) programs are interventions where patients use at-home devices to track their blood pressure and can be effective at improving control. Research Questions: The Ohio State University Total Health Care Center sought to improve HTN control rates, especially among non-Hispanic Black patients by implementing an SMBP program. Methods: Patients with HTN were referred to the SMBP program by their Primary Care Provider (PCP). Enrollment consisted of a 60 minute education session with an RN, where a personalized HTN care plan was developed, bluetooth blood pressure cuff and apps were setup, and patients received education for lifestyle modifications aimed at reducing blood pressure. After enrollment, PCPs would receive bi-weekly readings through the EMR and schedule a follow-up appointment within 30 days. A multidisciplinary approach was taken, where patients could receive care from a pharmacist, a dietitian, a counselor, or community health worker. Results: HTN control rates overall in the Health Center increased over time (58.08% in 2020 to 66.14% in 2023). Patients enrolled in SMBP had significantly higher control rates (77.78% vs.66.14%) than patients not enrolled in SMBP. Black patients enrolled in the SMBP program had higher control rates (74.38%) than White patients not participating in the SMBP program (72.73%), eliminating the racial disparity. When classified according to very low engagement (<5 readings), low engagement (6-19), moderate engagement (20-39), and high engagement (>40), the very low engagement group had the lowest control rates (69.05%) and steadily increased with engagement (84.38%, 86.36%, and 86.96%, respectively). Conclusion: Implementation of an interdisciplinary approach was effective in creating a successful SMBP program. Patients enrolled in SMBP had significantly higher control rates than patients not enrolled. Control rates increased with more engagement, peaking at moderate engagement and plateauing after that. Control rates increased significantly for Black patients, even exceeding that of white patients SMBP can be an effective strategy for eliminating racial disparities for hypertension control.