Abstract 167: An Innovative mHealth-based Care Model for Improving Hypertension Control in Stroke Survivors

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Background: Hypertension (HTN) is the most important modifiable risk factor for stroke prevention. Unfortunately, HTN is considerably under-treated in stroke survivors.Purpose: Our AHRQ funded study (R21 HS021794) examined the usability and feasibility of a mHealth (mobile health technology) based care model for improving HTN control rates in stroke survivors.Methods: Design was a 2 group randomized controlled trial. Total study duration was 120 days. HTN control was defined as Systolic BP (SBP) less than 140 mm Hg based on the AHA stroke guidelines. HTN control was evaluated in participants at study enrollment and completion. Intervention Group: Patients used a smart phone and wireless BP monitor to measure their BP. Patients were requested to measure their BP daily which was transmitted automatically to the study database. Study investigators (Physician + PharmD) reviewed BP weekly and, made needed medication adjustments bi-weekly. Primary care providers (PCP) were involved in the decision making via the electronic medical record. Control Group: Patients received a digital BP monitor and were educated on the importance of HTN control and asked to follow up with their PCP as usual (usual care). Intervention patients completed a Marshfield System Usablity Survey. Possible responses to usability questions were 1=strongly disagree, 2=agree, 3=neither agree or disagree, 4=agree, 5=strongly agree.Results: Total 50 patients completed the study (Table). Intervention patients transmitted BP a total of 92% of observation days and, rated mHealth as highly usable, Mean Marshfield System Usability Survey question response “I thought the system was easy to use” was 4.7. HTN control was significantly more effective in the intervention group (Table).Conclusion: A mHealth based model of HTN care was highly feasible and clinically more effective than usual care in stroke survivors. We propose that this care model be evaluated at a health system level.

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