Patient Characteristics Associated with Intentions to Use a Blood Pressure Telemonitoring Device Among Adults with Hypertension in the United States

OBJECTIVES: Blood pressure telemonitoring (BPT) may offer individuals with hypertension a convenient way to reduce cardiovascular risk. Acceptability among patients is one of the challenges limiting BPT use. This study characterized the US adult population with hypertension based on their amenability to using BPT devices.

METHODS: This cross-sectional study analyzed self-reported data from the 2023 US National Health and Wellness Survey, a nationally-representative, online-based survey. Adults (aged ≥18 years) diagnosed with hypertension without current BPT device use were categorized based on whether they did (BPT-Yes) or did not (BPT-No) intend to use a BPT device. Variables included sociodemographic and health characteristics, patient activation (PAM), health-related quality of life (HRQoL: 5-Level EQ-5D, RAND-36), work productivity and activity impairment (WPAI), and past 6-month healthcare resource utilization (emergency room [ER] visits, healthcare provider [HCP] visits, hospitalizations). Groups were compared on all study variables using chi-square or 2-sample t-tests.

RESULTS: BPT-Yes (n=1,678) was younger (mean: 57.4 vs. 65.0 years) and more often female (57.9% vs. 51.6%), Black/African American (22.8% vs. 10.2%), and Hispanic/Latino (10.1% vs. 4.8%) than BPT-No (n= 4,270); all, p<0.001. Groups did not differ on HCP visits; BPT-Yes (vs. BPT-No) nearly twice as often had ≥1 ER visits (20.4% vs. 11.2%) and hospitalizations (14.2% vs. 7.3%); both, p<0.001. BPT-Yes had lower mean EQ-5D index scores (0.76 vs. 0.80) and greater mean overall work productivity loss (28.9% vs. 17.9%); this same pattern of worse outcomes for BPT-Yes, relative to BPT-No, was observed on all HRQoL and WPAI metrics; all, p<0.001. Groups did not differ on PAM scores.

CONCLUSIONS: Experiencing serious medical events and greater impairment to work productivity, non-work activities, and HRQoL were associated with the intention to use BPT devices. Findings can inform patient-clinician discussions about whether BPT devices should be incorporated as part of a multifaceted, personalized approach to hypertension management.