RT Journal Article
SR Electronic
T1 Evaluating a large-scale roll out of blood pressure telemonitoring using routinely acquired data
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP bjgp19X703529
DO 10.3399/bjgp19X703529
VO 69
IS suppl 1
A1 Brian McKinstry
A1 Vicky Hammersley
A1 Richard Parker
A1 Hilary Pinnock
A1 Paul Padfield
A1 Janet Hanley
A1 Andrew Stoddart
A1 Adam Steventon
YR 2019
UL http://bjgp.org/content/69/suppl_1/bjgp19X703529.abstract
AB Background 1.2 million appointments in Scottish primary care annually are used solely for checking blood pressure (BP). While evidence from randomised controlled trials (RCTs) shows that telemonitoring of BP produces significant reductions, it has not been mainstreamed because of difficulties in integrating telemonitoring with routine medical care. With NHS Lothian a system was developed which extracted data from a telemonitoring provider website, and delivered it as a routine DOCMAN report to GP practices without need for logons.Aim To determine the feasibility of implementing telemonitoring of high blood pressure (HBP) at scale in primary care and the potential of using routinely acquired data for exploring clinical and resource-use impacts.Method Practice recorded BP, prescribing, and appointments data were transferred for all people with HBP to a safe-haven. We compared before and after BPs at 1 year from participants and non-participants. Patient and clinician interviews.Results Over 2400 people were recruited to telemonitoring overall. Over a year, BP control improved in both telemonitoring participants and non-participants. Mean systolic BP (SBP) fell by 6.6 mmHg in participants and 3.5 mmHg in non-participants. In uncontrolled participants (SBP >135 mmHg home-monitored) average fall was 15 mmHg. Proportion with very poor control BP (SBP >150 mmHg) fell from 13.6% to 3.4%. Appointment data were challenging to interpret, but there was little change from the previous year in face-to-face appointment time and total appointments. Patients and clinicians were positive about the implementationConclusion The study demonstrated an improvement in BP control similar to effects in RCTs in routine general practice with little impact on workload using routinely acquired data providing strong support for mainstreaming low-cost telemonitoring for HBP.