ORIGINAL RESEARCH
Arindam Sarkar, MD; Chinwe Nwokocha, MD; Susan G. Nash, PhD; Larissa Grigoryan, MD, PhD
Corresponding Author: Arindam Sarkar, MD; Baylor College of Medicine, Department of Family and Community Medicine
Email: arindams@bcm.edu
DOI: 10.3122/jabfm.2023.230357R1
Keywords: Blood Pressure, Hypertension, Minority Health, Patient Adherence, Primary Health Care, Prospective Studies,Surveys and Questionnaires, Telemedicine, Vulnerable Populations
Dates: Submitted: 10-01-2023; Revised: 11-21-2023; Accepted: 12-04-2023
FINAL PUBLICATION: |HTML| |PDF|
INTRODUCTION: Effective management of hypertension (HTN) is a priority in primary care. With telehealth now considered a staple care delivery method, uninsured and low-income patients without home blood pressure (BP) monitors may need additional attention and resources to achieve successful HTN control.
METHODS: This prospective study at an underserved community clinic assessed the impact of distributing free BP monitors on patients’ HTN control and therapy adherence. Enrollees were randomized into two groups, both completing four primary care physician (PCP) visits over a six-month study period. Intervention participants collected home BP readings to report to their PCP and comparison participants completed an equivalent number of visits without having home BP data available for their PCP to review. Both groups completed an initial and final Therapy Adherence Scale (TAS) questionnaire.
RESULTS: 263 patients were invited and 200 participants (mean age 50, 60% female, 19% Black, 67% Hispanic) completed the study. Intervention and comparison subjects featured comparable initial BP levels and TAS scores. After adjusting for age, race, ethnicity, sex, presence of diabetes and therapy adherence, intervention participants experienced higher odds of controlled HTN (OR 4.0; 95% Confidence Interval 2.1-7.7). A greater proportion of participants achieved BP control in the intervention arm compared to the comparison arm (82% versus 54% of participants, P<0.001). TAS scores were higher in the intervention group (Mean=44.1 versus 41.1; P<0.001).
DISCUSSION: The provision of free home BP monitors to low-income patients may feasibly and effectively improve BP control and therapy adherence.