Clinic visits were associated with a significant short-term increase in the number of home blood pressure measurements compared to the pre-visit baseline (p=0.0073).
RCT (n=82)
open-label
randomized
No
Does a clinic visit influence adherence to home blood pressure monitoring in hypertensive patients using a telemedical care system?
Clinic visits are associated with a short-term increase in home blood pressure monitoring adherence, suggesting that regular clinical contact may boost patient engagement in telemonitoring.
p-value: p=0.0073
Objective: SOT-ART-HT is a single-center, randomized, controlled, open-label trial evaluating a telemedical care system for patients with hypertension, using recommendation algorithms to support clinical decisions. The aim of this analysis was to describe how patients’ adherence to home blood pressure monitoring changes immediately before and after a clinic visit.Design and method: The analysis used data from patients who have completed the 6-month follow-up, that is 104. Patients who performed fewer than an average of 1 measurement per day over the entire study were excluded (recommended: 4 measurements per day). Data from 82 participants was analysed. Home BP measurements were aggregated into 7-day rolling sums around each qualifying clinic visit (windows -21 to +30 days), normalized by subtracting the baseline window (-21 to -15). Points were labeled by the right edge of each window. Additional analyses stratified the cohort by sex and age categories (60 years). Results: Values are close to baseline before the visit (with a slight dip immediately before), followed by a clear increase after the visit with a peak in the first days/weeks, and then a gradual decline, although the level remains above baseline for most of the post-visit period within the observed time window. The pre- vs post-visit difference was assessed with a paired sign-flip permutation test, showing a significant increase after the visit (p=0.0073). The post-visit increase is strongest in the 40+ groups, while the youngest shows a much smaller rise and often stays below baseline (statistically significant from 15 day post-visit). Both sexes show a post-visit rise followed by a gradual decline, but women display consistently higher values than men across most of the post-visit window (p>0.05) and just before the visit (p<0.05). Conclusions: Clinic visits are associated with a short-term increase in the number of home BP measurements, followed by a gradual decline. Age and sex may influence these associations, but their role remains uncertain. This type of analysis may help identify strategies to motivate patients to perform home measurements if telemonitoring is to be implemented more widely.
Lipski et al. (Fri,) conducted a rct in hypertension (n=82). Clinic visits vs. Pre-visit baseline was evaluated on Change in adherence to home blood pressure monitoring (number of measurements) (p=0.0073). Clinic visits were associated with a significant short-term increase in the number of home blood pressure measurements compared to the pre-visit baseline (p=0.0073).