Abstract
Background
Uncontrolled hypertension constitutes a significant challenge throughout the world.
Blood pressure measurement by patients is informative for both patients and providers
but is rarely performed systematically, thereby reducing its utility. Mobile phones
can be used to efficiently prompt individuals to measure blood pressure and automate
data management while avoiding technology barriers to widespread adoption. Presented
is the design and pilot test results of MyBP, an automated texting intervention to support blood pressure self-monitoring and
patient self-management.
Methods
Three sequential phases are described: (1) stakeholders’ needs assessment, (2) preliminary
design pilot (n = 10), and (3) a 6-week pilot of the redesigned comprehensive program
with hypertensive patients (n = 43) recruited from 3 clinical sites (Emergency Department,
Primary Care, Hypertension Center). Outcomes of interest included participant adherence,
perceived importance of blood pressure monitoring, and healthy behavior change.
Results
Median adherence to MyBP prompts over 6 weeks was 79% (72% emergency department, 84% primary care, and 96%
hypertension center, H[2] = 5.56, P = .06). Adherence did not vary by age, sex, education, or baseline use of texting
but was lowest among patients recruited from the emergency department (χ[2]2 = 6.66, P = .04). In the exit survey, MyBP was associated with increased importance of blood pressure self-monitoring and particularly
motivated primary care and emergency department groups to improve dietary habits,
increase daily physical activity, and focus on stress reduction. The majority of participants
(88%) indicated interest in using the program for 6 months.
Conclusions
Automated mobile-phone–based blood pressure self-monitoring using MyBP is feasible, acceptable, and scalable, and may improve self-management and support
clinical care.
Keywords
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Article info
Publication history
Published online: May 25, 2018
Accepted:
April 20,
2018
Received in revised form:
April 19,
2018
Received:
March 21,
2018
Footnotes
Funding: The University of Pittsburgh Physicians Academic Foundation provided seed funding.
Conflict of Interest: None.
Authorship: Authors TI, MA, JE, and MFM were involved in the direct data analysis. All authors were involved in conceptualization of the MyBP program and directly contributed to writing and iteratively revising the manuscript.
Identification
Copyright
© 2018 Published by Elsevier Inc.
