Year of Publication

2021

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Dr. Tyler Browning

Committee Member

Dr. Lynne Jensen

Abstract

Background: Hypertension remains one of the most common chronic conditions in the United States leading to several health complications and immense financial burdens, yet it remains grossly undertreated despite the availability of evidence-based treatment options. The 2017 guidelines from the American College of Cardiology and American Heart Association recommended the use of home blood pressure monitoring with a telehealth component as an adjunct to regular hypertension treatment; however, implementing this into practice can be difficult depending on the setting, available resources, and the knowledge and skills of the providers. Aims: The purpose of this investigation is to evaluate patient adherence of measuring and logging blood pressure on the electronic medical record patient portal and the provider offering feedback regarding treatment. A secondary aim is to evaluate blood pressure trends of patients pre- and post-intervention. Methods: A retrospective and prospective study was completed to evaluate patient and provider adherence to using the recommended home blood pressure monitoring with telehealth transmission. The goal was for patients to take and log blood pressure daily for a minimum of two weeks. The number of blood pressures used to assess adherence was 12 blood pressures in a one-month period. The provider was expected to follow up anytime within the month period. Change in systolic and diastolic blood pressure was also assessed. Results: Nine patients met the inclusion criteria and all nine patients participated in the telehealth intervention. Six (66.7%) were adherent and logged at least 12 blood pressures, seven (77.8%) logged at least 11 blood pressures and two participants (22.2%) logged no blood pressure measurements. Provider feedback was given to the seven participants (77.8%) who logged data. All patients who logged blood pressure measurements were within goal or near goal at the end of the intervention. Discussion/Implications: High levels of provider and patient adherence to the intervention suggest this intervention was an acceptable and feasible cointervention for the management of hypertension in the primary care setting and could be successful for the other patients with hypertension in this clinic and beyond.

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