We aimed to assess the feasibility of a text messaging intervention by determining the proportion of emergency department (ED) patients who responded to prompted home blood pressure (BP) self-monitoring and had persistent hypertension. We also explored the effect of the intervention on systolic blood pressure (SBP) over time.
We conducted a randomized, controlled trial of ED patients with expected discharge to home with elevated BP. Participants were identified by automated alerts from the electronic health record. Those who consented received a BP cuff to take home and enrolled in the 3-week screening phase. Text responders with persistent hypertension were randomized to control or weekly prompted BP self-monitoring and healthy behavior text messages.
Among the 104 patients enrolled in the ED, 73 reported at least one home BP over the 3-week run-in (screening) period. 55/73 reported a home BP>=140/90, and were randomized to SMS Intervention (n=28) or Control (n=27). The intervention group had significant SBP reduction over time with a mean drop of 9.1 mm Hg (95% CI 1.1 to 17.6).
The identification of ED patients with persistent hypertension using home BP self-monitoring and text messaging was feasible. The intervention was associated with a decrease in SBP likely to be clinically meaningful. Future studies are needed to further refine this approach and determine its efficacy.