Hypertension 2025 Scientific Sessions  /  Poster Session 1 and Reception (includes TAC Poster Competition)  /  Nurse support for remote monitoring of hypertension reduces burden on primary care physicians and increased responsiveness to alerts
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American Heart Association

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Final ID: TH125

Nurse support for remote monitoring of hypertension reduces burden on primary care physicians and increased responsiveness to alerts

Abstract Body:
Introduction:
Remote blood pressure (BP) monitoring use to improve hypertension control is increasing but can lead to alert fatigue and primary care physician (PCP) inaction.

Hypothesis
The hypothesis is that team-based care with nurses attenuates remote monitoring alert fatigue in PCPs and that there are differences in the volume and outcomes of BP alerts by race and ethnicity.

Methods:
A retrospective cohort study was conducted with 405 patients that graduated from a virtual care disease management program (VCDM) at a Midwestern health system since 2021. The 12-week VCDM program included remote BP monitoring with weekly web-based education and team-based care supported by two nurses. Alerts were triggered for out of range BPs and reviewed by nurses every morning. PCPs received notifications if remote BPs demonstrated a trend of uncontrolled BPs over five or more consecutive days.

Two investigators developed a codebook to classify alerts and their outcomes. Medication intensification data was extracted manually. Charts were reviewed until thematic saturation was achieved from reviewing the last 20 charts. Chi square test was used to determine association between alert outcomes and race/ethnicity.

Results:
Thematic saturation was reached after reviewing 100 patient charts (mean age 65 years, SD 12, 42% Black, 48% female). Of the total recorded 340 alerts, 90% were managed by nurses without need for PCP notification. The most common follow-up nurse action for alerts (85%) was to continue BP monitoring and education. Only 23 alerts led to PCP messages or visits. Medication intensification occurred in response to all PCP messages and visits, resulting in a total of 25 medication intensifications. There was no significant difference in alert volume by race and ethnicity and medication intensification was more frequent in Black participants compared to White participants.

Conclusions:
In conclusion, integrating nurse support in remote BP monitoring programs significantly reduces PCP alert fatigue, enabling PCPs to focus on more complex cases requiring medication adjustments or in-person visits. Nurse monitoring enhanced patient safety through timely responses to abnormal BP readings. A structured protocol for handling alerts was effective in managing 90% of remote monitoring alerts. Future research should explore long-term health outcomes and reimbursement structures to support team-based remote monitoring and improve hypertension outcomes.
  • Mallu, Pranava  ( Case Western Reserve University , Cleveland , Ohio , United States )
  • Kim, Eric  ( Metro Health , Cleveland , Ohio , United States )
  • Love, Thomas  ( Metro Health , Cleveland , Ohio , United States )
  • Dreher, Nick  ( Metro Health , Cleveland , Ohio , United States )
  • Einstadter, Douglas  ( Metro Health , Cleveland , Ohio , United States )
  • Kaelber, David  ( Metro Health , Cleveland , Ohio , United States )
  • Tarabichi, Yasir  ( Metro Health , Cleveland , Ohio , United States )
  • Patil, Sonal  ( Metro Health , Cleveland , Ohio , United States )
    • Author Disclosures:
    Pranava Mallu: DO NOT have relevant financial relationships | Eric Kim: No Answer | Thomas Love: No Answer | Nick Dreher: No Answer | Douglas Einstadter: DO NOT have relevant financial relationships | David Kaelber: No Answer | Yasir Tarabichi: No Answer | Sonal Patil: No Answer
Meeting Info:

Hypertension 2025 Scientific Sessions

2025

Baltimore, Maryland

Session Info:

Poster Session 1 and Reception (includes TAC Poster Competition)

Thursday, 09/04/2025 , 05:30PM - 07:00PM

Poster Session

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