Wake Forest University Health Sciences
Current clinic-based hypertension (HTN) management models have several limitations, resulting in episodic care that does not adequately support patients' self-care skills, and fails to achieve blood pressure (BP) control.
Telemedicine management of HTN (TM-HTN) can augment and overcome challenges by allowing more support for patients' HTN self-care skills, providing multiple home Blood Pressure values and overcoming failure to appropriately intensify treatment. TM-HTN consists of 1) home BP monitoring, 2) home BP based pharmacotherapy, and 3) telemedicine-based self-management support.
Inclusion Criteria: * Subjects must be African American or Black * experiencing socially disadvantage * Patients with systolic Blood Pressure ≥140 mmHg on their last two clinic visits and baseline systolic BP \>130 mmHg using the mean of two research BP values measured by trained staff * Subjects must be on stable Blood Pressure medications for the preceding 6 weeks Exclusion Criteria: * Unable to read or speak English * diminished ability to measure home Blood Pressure * chronic kidney disease ≥stage 4 * persistent/chronic atrial fibrillation * severe hypertension \>180/110 mmHg * acute he…
TM-HTN intervention includes tailored and frequent self-management support, home blood pressure monitoring, pharmacotherapy, and as-needed assistance for health-related social needs provided by pharmacists, nurses, community health workers, and social workers. This will be compared with usual care
This includes usual clinic based HTN care using routinely available clinic resources (e.g., community health worker, social worker). Clinicians can offer self-management support (e.g., dietician referral) or recommend a home BP monitor. These activities mirror current primary care practice.
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