DCT Demonstrates Ability of Digital Programs to Improve Care, Blood Pressure Management

Research from Brigham and Women’s Hospital is underlining the impact of an approach integrating digital care on blood pressure management in patients with uncontrolled hypertension.

An analysis of patients from the Digital Care Transformation (DCT) program, results indicate nearly 90% of patients were able to achieve blood pressure control after a median of 4 months within the program after a median of 9 years of uncontrolled hypertension.

A team-based care program designed to improve care through medical titration and education using physician-designed algorithms, DCT was created with the aim of addressing areas of need in multiple disease states, including hypertension. The present study, which was presented at the American College of Cardiology’s 70th Annual Scientific Session (ACC.21), sought to assess the benefits of the program on blood pressure control among patients who reached goal within the program.

For the purpose of analysis, investigators designed their analyses with the goal of qualifying time of exposure to hypertensive blood pressure in routine office care prior to referral and after enrollment in the program. Uncontrolled hypertension was defined as two or more blood pressure measurements exceeding 140/90 mmHg at separate visits in the same calendar year.

A cohort of 687 patients was identified for inclusion. These patients had been followed within the health system for a mean of 7.4 years prior to referral to DCT. The median time spent with blood pressure above goal was 4.6 years and the median time between first uncontrolled blood pressure year and enrollment in DCT was 8 years.

After a median of 4 months within the program, blood pressure control, defined as 130/80 mmHg or below, was achieved by 89% of patients. The mean blood pressure among this cohort was 125/72 mmHg and the mean number of medication changes was 2.8. The final mean blood pressure among the remaining patients was 135/82 mmHg. Investigators noted the mean total reduction of blood pressure observed within this cohort was 17±13/9±8 mmHg.

For more on the results of this study and how adoption of digital care practices could improve management of hypertension, check out this interview with lead investigator Naomi Fisher, MD, Director of Hypertension Service and the Hypertension Specialty Clinic at Brigham and Women’s Hospital.

This study, “Time to Control: Routine Clinical Care vs. Virtual Hypertension Management,” was presented at ACC.21.