A Randomized Controlled Trial for Hypertension Control by Integrating Cloud BP System and CPOE

Design, Setting and Patients: A randomized clinical trial study of 382 adults recruited from 786 patients who had been diagnosed with hypertension and receiving treatment for hypertension in two district hospitals in the north of Taiwan. Physicians had access to cloud-based BP data from CPOE. Neither participants nor investigators were blinded to group assignment. The study was conducted for a period of seven months.

Interventions: Patients from two hospitals were randomized into a control group which received traditional care (n=212) and an intervention group (n=170) which received a cloud-based home BP monitoring device. The device measured and transmitted BP data to the cloud server, which was integrated with the CPOE system in the hospitals. Physicians could access the BP data during the patient encounter to adjust the antihypertensive therapy accordingly. Meanwhile, patients could browse their own BP data from their computers, smart phones, tablets and so on.

Primary Outcome(s) and Measure(s): The primary outcomes were control of systolic BP to less than 140 mm Hg and diastolic BP to less than 90 mm Hg at two, four and six months. The secondary outcomes were changes in BP and antihypertensive drug prescription at two, four and six months.

Inclusion criteria

• Secondary hypertension
• Expectant mother
• Stroke, myocardial infarction or had surgery within 3 months
• Atrial fibrillation
• Inter-arm difference (IAD) >20 mm Hg
• Unsuitability as recognized by physicians.

Exclusion criteria

• Unable to participate in this trial for the whole process
• Lived alone and unable to read Text Message