Mobile Phone Based Remote Patient Monitoring System for Management of Hypertension in Diabetic Patients

Rising concern over the poor level of blood-pressure (BP) control among hypertensive patients has prompted searches for novel ways of managing hypertension. The objectives of this study were to develop and pilot-test a home BP tele-management system that actively engages patients in the process of care. Methods: Phase 1 involved a series of focus-group meetings with patients and primary care providers to guide the system’s development. In Phase 2, 33 diabetic patients with uncontrolled ambulatory hypertension were enrolled in a 4-month pilot study, using a before-and-after design to assess its effectiveness in lowering BP, its acceptability to users, and the reliability of home BP measurements. Results: The system, developed using commodity hardware, comprised a Bluetooth-enabled home BP monitor, a mobile phone to receive and transmit data, a central server for data processing,

A wide assortment of health care aids designed for the home is now available. For hypertension, they range from simple home BP monitoring devices to sophisticated tele-management systems. Experience with these aids to improve BP control has not been encouraging. Lack of reliable home BP monitoring devices, the need for wired connections of tele-management systems, the challenges of the Internet (especially for older individuals), the disruption of a normal workflow pattern for physicians, and the lack of direct communication with patients have greatly limited their effectiveness and contributed to their low level of adoption by physicians and patients. New solutions are required. This study describes the development and pilot-testing of a mobile phone– based remote patient monitoring system to improve BP control of hypertensive patients with diabetes. The system was developed (Phase 1) using an iterative process based on feedback from users. A pilot study (Phase 2) was undertaken to assess the system’s effectiveness in improving BP control in diabetic patients with uncontrolled hypertension, its acceptability to users, and the reliability of home BP measurements.

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