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Randomized feasibility trial of a digital intervention for hypertension self-management


Home blood pressure monitoring (HBPM) can improve hypertension management. Digital tools to facilitate routinized HBPM and patient self-care are underutilized and lack evidence of effectiveness. MyBP provides video-based education and automated text messaging to support continuous BP self-monitoring with recurring feedback. In this pragmatic trial, we sought to generate preliminary evidence of feasibility and efficacy in community-dwelling adults ≥55 y/o with hypertension recruited from primary care offices. Enrollees were provided a standard automatic BP cuff and randomized 2:1 to MyBP vs treatment-as-usual (control). Engagement with MyBP was defined as the proportion of BP reading prompts for which a reading was submitted, tracked over successive 2-week monitoring periods. Preliminary measures of efficacy included BP readings from phone-supervised home measurements and a self-efficacy questionnaire. Sixty-two participants (40 women, 33 Blacks, mean age 66, mean office BP 164/91) were randomized to MyBP (n = 41) or a control group (n = 21). Median follow-up was 22.9 (SD = 6.7) weeks. In the MyBP group, median engagement with HBPM was 82.7% (Q1 = 52.5, Q3 = 89.6) and sustained over time. The decline in systolic [12 mm Hg (SD = 17)] and diastolic BP [5 mm Hg (SD = 7)] did not differ between the two treatment groups. However, participants with higher baseline systolic BP assigned to MyBP had a greater decline compared to controls [interaction effect estimate −0.56 (−0.96, −0.17)]. Overall hypertension self-efficacy improved in the MyBP group. In conclusion, trial results show that older hypertensive adults with substantial minority representation had sustained engagement with this digital self-monitoring program and may benefit clinically.

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Fig. 1: Engagement with MyBP program.
Fig. 2: Engagement time trend.
Fig. 3: Scatter plots of change in systolic BP as a function of baseline systolic BP.


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We gratefully acknowledge the following organizations and individuals whose contributions were integral to the successful completion of this investigation: The Aging Institute of UPMC Senior Services for funding; Patients, providers, and staff from area regional primary care offices who participated or assisted in the study; Mr. Jack Doman who programmed MyBP; Emmi Solutions, Inc. whose hypertension education videos were used through a lease agreement with UPMC Health System.

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Correspondence to Matthew F. Muldoon.

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Muldoon, M.F., Einhorn, J., Yabes, J.G. et al. Randomized feasibility trial of a digital intervention for hypertension self-management. J Hum Hypertens 36, 718–725 (2022).

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