Mobile technology is fueling new frontiers in healthcare, promising easier management of chronic conditions through applications that send reminders, record readings, track trend lines, and allow users to share results with their clinician at the push of a button. In theory, such apps will drive better engagement and accountability, improving health outcomes. But do the apps live up to the hype? New research results from a PCORnet-powered study, published in JAMA Internal Medicine, say the answer is ‘not always’ when it comes to smart blood pressure apps.
The study team used PCORnet to conduct a large pragmatic clinical trial comparing the effectiveness of managing uncontrolled blood pressure across two randomized groups: one performing self-measurement with a standard home monitor (the usual wrap cuff with output on the device), and the other using a similar device enhanced with a connected smartphone application. The app reminded participants to check blood pressure and featured measurement tracking, interpretation, annotation and visualization tools. It also supported users in emailing a summary of their measurements to a clinician.
Newly released results from the study suggest that there is no significant advantage to using the enhanced blood pressure monitoring device with a connected smartphone app versus a standard device. The group using the connected app did not experience any additional reduction in blood pressure, and no more of the patients who used the enhanced device would recommend it to their peers than those who used a standard device.
PCORnet as a facilitator for patient-centered insights
The results of this study are important because self-management of hypertension is becoming more commonplace due to the rise of telehealth care in recent years. Given that uncontrolled blood pressure contributes to 500,000 deaths per year in the U.S., a clear understanding of the most effective tools to support patients in effectively managing the condition is critical.
PCORnet was uniquely positioned to support the study because of its broad reach into a large percentage of the U.S. population. The Network’s established connections across major health systems and shared use of a Common Data Model to standardize disparate electronic health record (EHR) data codes allowed researchers to rapidly glean insights representative of a broad swath of America while minimizing the burden to study participants.
The study team used PCORnet to extract baseline data from EHRs of the 2,100 study participants. Then they compared those numbers to in-clinic blood pressure measurements from EHRs after six months using either the standard device or the enhanced device. The study team also conducted a short patient satisfaction survey.
Both groups had an apparent reduction of approximately 11 mm Hg from their baseline reading to their most recent office BP measurement. Satisfaction rates of participants assigned to the standard monitor or the enhanced monitor with app were statistically insignificant.
While these outcomes are consistent with prior literature, the study team supports future research to evaluate novel technologies that may better support blood pressure control.
