Development and Preliminary Feasibility of an Automated Hypertension Self-Management System.
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Abstract
BACKGROUND Uncontrolled hypertension constitutes a significant challenge throughout the world Blood pressure measurement by patients is informative for both patients and providers but is rarely performed systematically thereby reducing its utility Mobile phones can be used to efficiently prompt individuals to measure blood pressure and automate data management while avoiding technology barriers to widespread adoption Presented is the design and pilot test results of MyBP an automated texting intervention to support blood pressure self monitoring and patient self management METHODS Three sequential phases are described 1 stakeholders needs assessment 2 preliminary design pilot n 10 and 3 a six week pilot of the re designed comprehensive program with hypertensive patients n 43 recruited from three clinical sites Emergency Department Primary Care Hypertension Center Outcomes of interest included participant adherence perceived importance of blood pressure monitoring and healthy behavior change RESULTS Median adherence to MyBP prompts over six weeks was 79 72 Emergency Department 84 Primary Care and 96 Hypertension Center H 2 5 56 p 0 06 Adherence did not vary by age gender education or baseline use of texting but was lowest among patients recruited from the Emergency Department 2 2 6 66 p 0 04 In the exit survey MyBP was associated with increased importance of blood pressure self monitoring and particularly motivated primary care and emergency department groups to improve dietary habits increase daily physical activity and focus on stress reduction The majority of participants 88 indicated interest in using the program for 6 months CONCLUSIONS Automated mobile phone based blood pressure self monitoring using MyBP is feasible acceptable and scalable and may improve self management and support clinical care