The use of technology to assist in care and its effects on quality and costs have been a source of continuing disappointment. Remote monitoring of chronic disease patients has a fairly long history, with uneven results. A new study in the Journal of the American Medical Association suggests that at least one approach to remote monitoring may improve the care of people with hypertension. (JAMA Article) Hypertension is widespread among US adults and while it can be controlled with diet, exercise and inexpensive drugs, physicians have had difficulty keeping patients’ blood pressure in the desired range. Uncontrolled hypertension can lead to adverse events and health care utilization. In a trial conducted at HealthPartners, some patients were remotely monitored and received consulting from trained pharmacists. The pharmacists conducted regular phone visits and emphasized lifestyle changes and medication adherence. At six and 12 months, 57% of the study group had controlled blood pressure versus only 30% in the usual care group. This effect appeared to be maintained for at least 6 months following the end of the study. More drugs were prescribed for the study group and they reported higher adherence to the medication regimen. The cost of the intervention was about $1350 per patient per year. The researchers did not report outcomes related to utilization or cost, but it is highly possible that the intervention group had lower total health spending if their blood pressure was in significantly better control.
