Abstract
BACKGROUND: Traditional methods for treating hypertension have been ineffective. Remote patient care (RPC) can transform how we provide longitudinal care for patients with hypertension. OBJECTIVES: The purpose of this study was to determine whether an RPC hypertension program can provide a scalable solution for optimizing hypertension management, especially among rural/underserved patients. METHODS: A technology-enabled RPC provider enrolled patients into an RPC hypertension program from February 2022 to June 2024. Using vitals automatically transmitted from a cellular-enabled blood pressure (BP) cuff and scheduled visits, clinicians leveraged technology-enabled clinical protocols to drive engagement and improve hypertension control. Mean reduction in BP and percentage of individuals at BP goal were evaluated using a paired t-test and McNemar's test, respectively. RESULTS: A total of 23,638 patients were enrolled (mean [SD] age 73(9), 60.0% female, 56.9% rural/underserved) with a baseline BP of 140/81 mm Hg. The mean (SD) reduction in BP was 7/5 (14/8) mm Hg (P < 0.001) after a follow-up of 30 (24) weeks, with a greater reduction in individuals with a higher baseline BP. Clinical engagement was high (75% and 57% of patients still measuring vitals at 6 and 12 months, respectively) with 11,834,837 vitals measured, 177,620 clinical encounters and 118,792 phone calls completed, and 117,457 high-acuity clinical alerts resolved. There was a 70% relative increase in the number of patients at goal BP at follow-up (36.6% vs 21.5%; P < 0.001). Results among rural/underserved patients were similar. CONCLUSIONS: A nationwide RPC hypertension program can drive high patient engagement and facilitate clinical encounters at scale, resulting in reduced BP levels and more patients achieving BP goals across the United States.