Abstract 13682: Remote Hypertension Management During the COVID-19 Pandemic

Introduction: During the COVID-19 pandemic, much of routine chronic disease monitoring and management via outpatient visits was deferred, revealing a disruption in care delivery. We demonstrate that an established remote care delivery program enabled delivery of uninterrupted, effective care. Methods: The team-based Digital Care Transformation (DCT) program remotely manages hypertension via monitoring home blood pressure (BP) readings that are automatically transmitted, using a team of navigators who follow expert-designed titration algorithms. We examined all patients enrolled in this program during the first six months of the health emergency in Boston (3/15- 9/15/2020) to assess outcomes at a cutoff one year into the pandemic (3/15/2021). We also assessed healthcare utilization by analyzing monthly PCP and non-PCP visits, as well as BPs measured, in the year prior to enrollment compared to the study year 3/15/2020 - 3/15/2021. Results: 651 patients were enrolled and transmitted a home baseline BP during the first week. 475 patients (73%) had sustained hypertension according to home BPs. PCP visits decreased by 50% and non-PCP visits by 40% over this period (both p<0.001.) The weekly mean BP at program baseline was 145/84 + 15/9 mmHg, and at program exit was 135/79 + 15/10 mmHg (p<0.001.) Assessing the 240 patients who completed all follow-up, maintenance BP was 125/73 + 7/7 mmHg (p<0.001.) Control was reached with a mean 2.3 medication titrations. While in the program, patients received an average of 8.2 phone calls/month and recorded 32.4 individual BP measurements monthly. Conclusions: While in-person clinical care delivery during the COVID-19 pandemic decreased dramatically, an established remote health delivery program continued to deliver effective BP reduction and achieve clinical targets. Further study is warranted to understand the role remote care can play in hypertension management as we exit the pandemic.