Mobile phone-based remote patient monitoring system for management of hypertension in diabetic patients.

BACKGROUND Rising concern over the poor level of blood pressure BP control among hypertensive patients has prompted searches for novel ways of managing hypertension The objectives of this study were to develop and pilot test a home BP tele management system that actively engages patients in the process of care METHODS Phase 1 involved a series of focus group meetings with patients and primary care providers to guide the system s development In Phase 2 33 diabetic patients with uncontrolled ambulatory hypertension were enrolled in a 4 month pilot study using a before and after design to assess its effectiveness in lowering BP its acceptability to users and the reliability of home BP measurements RESULTS The system developed using commodity hardware comprised a Bluetooth enabled home BP monitor a mobile phone to receive and transmit data a central server for data processing a fax back system to send physicians reports and a BP alerting system In the pilot study 24 h ambulatory BP fell by 11 5 13 7 SD mm Hg both P Under 001 and BP control improved significantly Substantially more home readings were received by the server than expected based on the preset monitoring schedule Of 42 BP alerts sent to patients almost half n 20 were due to low BP Physicians received no critical BP alerts Patients perceived the system as acceptable and effective CONCLUSIONS The encouraging results of this study provide a strong rationale for a long term randomized clinical trial to determine whether this home BP tele management system improves BP control in the community among patients with uncontrolled hypertension