Self-management program helps patients lower blood pressure

A web-based employee self-management program helped individuals with pre-hypertension or hypertension achieve significantly lower blood pressure, according to the results of a clinical trial conducted by the Center for Connected Health, affiliated with Partners HealthCare in Boston.

The study, published in the October issue of the American Heart Journal, examined a six-month controlled trial conducted at a Massachusetts corporation. Just more than 400 employees with pre-hypertension or hypertension participated in a web-based program that enabled individuals to easily collect their blood pressure readings, monitor trends and securely share their personal data with their providers using a home blood pressure cuff and web portal.

"Our findings indicate that self-management can be an effective way to improve blood pressure control in an employee population. We believe the workplace is an excellent setting for implementing this model of disease management," said Joseph C. Kvedar, MD, founder and director of the Center for Connected Health. "Shifting interventions from the clinic to home and workplace is an innovative and potentially effective approach to achieving increased patient involvement in and responsibility for their own care, improving quality of life and clinical outcomes, while reducing healthcare costs."

The change in diastolic blood pressure was significantly different between the intervention and control groups, although the change in systolic blood pressure was not significant. Nearly one quarter of intervention participants experienced a greater than 10mmHg decrease in systolic blood pressure (22 percent), or a greater than 5mmHg decrease in diastolic blood pressure (29 percent) compared to the control group. Intervention participants were twice as likely to report starting a new medication and more likely to report improved communication with their doctor. Just a 5mmHg decrease in blood pressure can reduce mortality due to stroke and heart disease by 14 percent and 9 percent, respectively.

Participants randomized to the intervention group received a home blood pressure monitor, which transmitted their data to a secure, password-protected website. The website allowed participants to track their blood pressure readings over time, access educational material and receive automated, tailored messages based on their data, advice on when to seek medical care and reminders and motivational messages.

Based on this self-management technology platform developed at the Center for Connected Health, Healthrageous, a digital health management company, was founded, offering a personalized technology to prevent and self-manage chronic health conditions. The Center's Blood Pressure Connect program is also offered to patients throughout the Partners HealthCare network, including Massachusetts General and Brigham and Women’s Hospitals in Boston.