Abstract P326: Engaging Patients In Home Blood Pressure Monitoring

The COVID-19 pandemic resulted in fewer clinic-based blood pressure (BP) measurements and worsening hypertension control, but new opportunities for taking hypertension care out of the office and into patients homes using self-measured BP (SMBP). Methods: We performed a mixed methods study of 6489 patients at Kaiser Permanente Washington with hypertension had high BP ( > 140/90 mmHg) at their last clinic encounter and had received a secure email message requesting a follow-up BP, either by sending in a home BP measurement by secure email or coming into clinic for a kiosk or medical assistant BP measurement. Quantitative assessments included the percent and characteristics of patients: 1) with BPs in the EMR at 3 months versus no BP; 2) clinic BPs versus home BPs; and 3) controlled vs uncontrolled BP (HEDIS definition). We conducted semi-structured phone interviews with 22 participants from the quantitative cohort, oversampling from those who sent in home BPs and identified key themes and made recommendations to the delivery system for engaging patients in home BP monitoring. Results: Of the 6489 individuals, 53.8% had a BP in the EMR in the 3 months after the outreach attempt, Individuals with a BP were more likely to be older (age 65+, 64.9%), women (58.3%), and white race (58.0%). Individuals with no BP in the EMR were more likely to be less than age 50 and Asian Of the patients with a BP in the EMR by 3 months and a primary care or email encounter, 81.1% (2021) had a clinic BP and 18.9% (467) had a home BP. People identified as White race were most likely to have a home BP, whereas people identified as Black race were least likely (20.5% vs. 9.5%). Home BPs were significantly more likely to be <140/90 mmHg as compared to clinic BPs (75.6% versus 52.4%, P<0.001). Important themes from interviews included variation in patient understanding of high BP and BP targets, questions about selection of BP monitors and measurement schedules, preferences for telehealth and follow-up communications, and needs for educational support. Discussion: Most follow-up BPs were clinic-based. Quantitative assessment revealed disparities in uptake of home BP measurement. Qualitative assessments provided insights for program design and increasing patient engagement in SMBP.