NCT03116815

The Feasibility of a Web-based Application to Monitor Home Blood Pressure

Official Title:

The Feasibility of a Web-based Application to Monitor Home Blood Pressure

Summary

Control of hypertension remains one of the most important interventions available to clinicians to reduce risk of cardiovascular disease, kidney disease and stroke. Self-measured home blood pressure monitoring plus additional support has been shown to reduce blood pressure in adults with previously uncontrolled hypertension. Most previous studies have utilized healthcare personnel to facilitate communication of home blood pressure levels to physicians and did not provide methods to directly transmit self-measured blood home blood pressure levels to physicians via the electronic health record. Emerging technology now provides the ability for patient's to upload self-measured blood pressure levels into their own medical record which may eliminate the need for additional health personnel. This study will examine the feasibility, patient adherence and physician and patient perceptions of a web-based application which will facilitate direct input of self-measured home blood pressure levels and patient reported symptoms directly into the electronic health record with message alerts to the provider for hypertension management. Up to 10 Loyola primary care physicians and 20 of their respective patients age 50 years and older who have a smart phone device or home computer and have treated hypertension will be enrolled. The study will utilize the existing web-application called MyChart. MyChart is the name of the web-based application and it is not an acronym. Enrolled patients will download the existing MyChart web-based application on their smart phone device or home computer and will record home blood pressure measurements using their home blood pressure machine into their smart phone application. The MyChart application is available to all patients receiving care in the Loyola Health Care System. The blood pressure readings and patient reported symptoms will then be available for their physicians to review within the electronic health record. After using the web-based application for two months, both patients and physicians will be asked to participate in focus groups and interviews, respectively, to determine their perceptions and satisfaction with the web-based application. Data from this feasibility study may be used to guide a future clinical trial of hypertension management that examines the effectiveness of the MyChart web-based application for frequent blood pressure monitoring compared to standard care.

Eligibility

* Inclusion Criteria:

* Willing to participate in all study procedures
* Potential subject owns a personal device and is able to run the web-application
* Physician directed blood pressure goal is \< 140/90 mmHg
* Exclusion Criteria:

* No use of blood pressure lowering medications
* Arm circumference too large or small to allow accurate blood pressure measurement
* A medical condition likely to limit survival to less than 6 months, or a cancer diagnosed and treated within the past two years that, in the judgment of clinical study staff, would compromise a participant's ability to complete the study
* Inability to give informed consent
* History of systolic heart failure (ejection fraction \< 35%)
* History of stroke
* History of proteinuria ≥ 1 gram in a 24 hour urine collection or a random urine albumin/creatinine ratio ≥ 300 mg/g or a random urine protein/creatinine ratio ≥ 300 mg/g

Disease(s) and\or Condition(s)

Hypertension

Primary Purpose
  • OTHER
Intervention/Treatment
    • Type: OTHER
    • Name: Direct input of home blood pressure readings via MyChart
    • Description: Participants will record home blood pressure readings directly into the electronic health record via the MyChart application
    • Arm Group Labels: Intervention
Sponsor
  • Loyola University