MedicalResearch:
Dr. Linnea A. Polgreen, Ph.D. Many patients with hypertension are unaware that they have
hypertension. Furthermore, a substantial number of patients diagnosed
with hypertension are poorly controlled. Unfortunately there is no
point-of-care test to diagnose hypertension. For most patients with
multiple to moderate hypertension, multiple measurements are needed over
time to confirm the diagnosis. This need to obtain multiple measurement
often delays the diagnosis of hypertension, and delays potential for
changes in therapy for those who are diagnosed but poorly controlled.
Patients are routinely reminded to check their blood pressure
measurements at home. However, these measurements often do not occur or
are not collected in a timely fashion. Recently electronic medical
records (EMRs) have built portals for patients to enter data such as
blood pressure measurements, but it is unclear how effective these
portals will be for diagnosing and treating high blood pressure.
We
studied 121 patients with at least one high blood pressure measurement
in the past year and randomized them to three groups.
- The first group received text messages to which they were told to reply with their blood pressure measurements.
- The second group was sent text messages reminding them to enter their blood pressures measurements in the hospital’s EMR portal.
- The third group was instructed to enter their blood pressure
measurements in the EMR portal, but they were not given reminders.
Automated messages were sent to each patient in the bi-directional text
messaging and EMR+reminder groups twice daily for up to 15 days. For the
EMR only group, only 47.8% of patients successfully recorded a total of
14 blood pressure measurements within 15 days. For the EMR + reminder
group, this percentage was 81.2%, and for the bi-directional text
messaging group, it was 97.7%.
Providing patients with electronic medical record portals may not be
enough. We found that reminders were very important for increasing the
number of blood pressure measurements.
Efforts to incorporate reminder systems can increase adherence to
home blood pressure monitoring. Future studies should focus on how reminder systems can help improve control of hypertension.
