Keywords: mHealth application, hypertension, family doctor, ,, face to face " visit

Background:

Hypertension is a leading cause of overall morbidity and mortality worldwide. The use of telemonitoring opens new opportunities for close monitoring of patients with hypertension through self-monitoring of blood pressure at home and timely transfer of these values to primary care physicians.

Research questions:

Will the use of the mHealth application improve the management of patients with newly diagnosed hypertension at the primary health care level?

Method:

A prospective randomized controlled multicenter study with 12-months follow-up of newly diagnosed patients with hypertension. The intervention group received standard care + mHealth application, while the control group received standard care only. The mHealth application enabled transmission of measured blood pressure values in real time and two-way doctor-patient communication via SMS messages. The study monitored blood pressure control and the number of additional visits in the primary care clinic.

Results:

95 participants in intervention group and 97 in control group were recruited. After 12 months, in the intervention group for systolic blood pressure a decrease of 26 mmHg was recorded, i.e. by 21 mmHg (Mann-Whitney U Test: Z=[-2,793; p=0,005) in the standard care group and 15.5 mmHg, i.e. by 12.7 mmHg (Mann-Whitney U Test: Z=[-3,182; p=0,001) for diastolic blood pressure in the intervention and control groups, respectively, with a significant statistical difference in all 4 follow-up times after the intervention. 24.21% from the participants in the intervention and 53.61% in the control group (Difference test: 29,40% [(15,69-41,58) CI 95%) had an additional visit in the clinic. No adverse events were recorded in either group.

Conclusions:

An mHealth application with two-way patient-physician communication represents an additional intervention to standard care that can improve hypertension management at the primary care level and provides an opportunity for better organization of work in family doctor outpatient clinics.

Points for discussion:

Is an mHealth application suitable for use by all patients, especially the elderly population?

Can an mHealth application to a greater extent replace the management of HTN in the family doctor's outpatient clinic?