[PP.25.42] NOVEL HYPERTENSION MANAGEMENT MODEL OF CARE DECREASES BLOOD PRESSURE IN WEST AFRICAN POPULATION. (September 2017)

• Record Type: Journal Article
• Authors: Owusu, I. Kofi; Adomako-Boateng, F.; Grossman, D.; Kueffer, F.; Guy, M.; Lang'At, C.; Whitman, T.; Holloman, K.; Opare-Sem, K.O.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523897.60784.eb
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Background: Geographic, socioeconomic, and cultural factors create significant barriers to effective blood pressure (BP) control in many developing countries, including the Republic of Ghana where the incidence of hypertension is greater than 30%. A novel hypertension management model of care was developed to address these barriers and to improve patient management and outcomes. Methods: A total of 150 patients were enrolled and agreed to visit a participating local community pharmacy at least once per week for 6 months for a BP assessment, which included BP check, symptom questions, and medication adherence monitoring. Data were entered into a custom mobile application that generated immediate personalized feedback. Using the mobile application, the patient's primary physician viewed real-time BP assessment data, provided patients with feedback on their condition via text message, and wrote electronic prescriptions accessible to participating pharmacies. Design and method: Mean age was 57 ± 8 years; 73% were females; average time since hypertension diagnosis was 9 ± 8 years. Average baseline BP was 135 ± 18/ 84 ± 10 mmHg. After 6 months of voluntary weekly monitoring, systolic blood pressure (SBP) dropped by -4.8 ± 18.2 mmHg (p < 0.01). The subset of 58 subjects (39%) with uncontrolled pressure (SBP ? 140 mmHg) at baseline showed greater reductions in systolic pressure (-15.6 ± 17.1 mmHg; p < 0.01). The proportion of the population with uncontrolled hypertension decreased from 39% to 27% over 6 months (p = 0.02). Diastolic blood pressure also decreased. Patient compliance with weekly BP assessments was 65% and 2734 total pharmacy BP assessments were conducted. The mobile application logic directly referred 25 patients to a health facility during 33 visits (1% of pharmacy visits). No deaths occurred and six patients required inpatient hospitalization, which included one stroke. Improvement in overall health awareness was reported in 82% of the patients and 95% indicated a desire to continue using the model of care in the future. Results: A novel hypertension monitoring and remote management application resulted in decreased blood pressure that was sustained over 6 months in this West African population. Results were driven by high levels of patient compliance and satisfaction and increased access to community based care