Blood pressure telemonitoring and remote counseling (BPTM) is mostly effective for management of patients with arterial hypertension (HTN). Nevertheless, its effectiveness decreases as the follow-up is prolonged, probably due to a loss of interest by patients.

OBJECTIVE

To determine the duration of active participation of patients with HTN in the BPTM project andto reveal the predictors of their engagement.

MATERIAL AND METHODS

Patients with uncontrolled HTN were included, BPTM suggested the home BP telemonitoring and text consultations with the doctor. Duration of the follow-up was 3 months. Mandatory initial and study end visits for measurement of the office BP, quality of life assessment (HYPE (HYpertension imPact quEstionnaire) were provided. Criteria for BPTM discontinuation absence of home BP data transmitted for 2 weeks and/or need for 2 reminders from the physician. Patients were divided into 2 groups: «quitted» and «continuing».

RESULTS

Ninety-two patients (69 men, median age 43 years) were included. Initially the median of office systolic BP (SBP) was 155 (144; 162) mm Hg, diastolic BP — 95 (90; 102) mm Hg. The office BP values have decreased significantly over the 3 months (–16 and –11 mm Hg, respectively; p<0.001). There has been a decrease in the level of home SBP (–8 mm Hg, p<0.001). Among those included in the study, 44 patients actively participated, 48 patients stopped their participation (85% of them — after 1 month). There have been no statistically significant differences between groups in the degree of BP decrease. Higher initial office SBP (ß=0.041, p=0.049), male sex (OR 4.15 (95% CI (2.01—4.06), p=0.044) and obesity (OR 3.7 (95% CI (2.06—4.24), p=0.039) were predictors of involvement. Quality of life after 3 months has been higher in the «continuing» patients (∆+9 scores, p=0.015).

CONCLUSION

Telemonitoring and remote counseling contribute to decrease of the office and out-of-office blood pressure level. Even motivated patients stopped active participation, predominantly female non-obese patients with mild HTN. Continuing patients experience a higher quality of life.