BP Call Back: A Patient-driven Workflow to Improve Control of Hypertension at Home during a Pandemic

06-21-2022 00:37

PURPOSE: Increased telehealth utilization in a pandemic imposed challenges to hypertension (HTN) care quality, as NCQA requires documented clinic BP<140/90 every year with recent acceptance of home digital arms cuffs as an alternative. METHODS: Our Family Medicine Center (14959 patients; 3955 with HTN) piloted a simple patient-driven protocol to address this care gap. Patients were notified of a dedicated BP phone line on a rolling basis, during in-person or virtual appointments, and told to provide 3 BPs taken by arm cuff over 1 week. Patients would receive call backs only if they were uncontrolled. Retrospective analysis of our 8-week pilot was done and primary endpoint was Number Needed to Treat (NNT) to meet our targets of 78% and 82%, for ages 18-64 and 65-75, respectively. RESULTS: Total NNT fell from 441 to 344, for an improvement of 22% after 8 weeks. NNT for African Americans fell from 54 to 36 (33% reduction). NNT for patients age 65- 75 fell 5% from 184 to 174. CONCLUSION: Direct line for home BP results with simple patient instructions is a promising tool to improve HTN control in primary care. Our current cycle, January to March 2021, includes more targeted enrollment efforts directed at seniors, with data to follow.

Author(s):Kimberly Ontiveros-Gomez BS, Payam Sazegar MD, Francesca Adriano MD, Vidush Athyal MD
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