Automatically Transmitted Home Blood Pressure and Automated Patient Feedback in Hypertension Care: the AUTO 2 Trial

Effects of Manually Recorded or Automatically Transmitted Home Blood Pressures With or Without Automated Patient Feedback on Hypertension Care

The purpose of this study is to evaluate the effectiveness of automatically-generated medical advice to patients about to their home blood pressure monitoring results sent through patient portal messages compared to no automated advice and the effectiveness of automated transmission of remotely-obtained blood pressure values compared to self-reported values on systolic blood pressure at 1-year follow up in patients with uncontrolled hypertension whose physicians or advance practice providers provide primary care at Northwestern Medicine. Persistence of effects through 18 months will also be assessed.

Inclusion Criteria:

• Age 18-84 years at enrollment date
• Receives hypertension care primarily from a participating clinician
• Blood pressure on the two most recent days when ambulatory clinic blood pressure was obtained prior to patient identification to was ≥140 mm Hg systolic and/or ≥90 diastolic or last ambulatory clinic blood pressure was ≥150 mm Hg systolic and/or ≥95 diastolic
• Currently has or is willing to obtain a patient portal account from NM.

Exclusion Criteria:

• Dementia,
• Nursing home resident,
• Stage 5 chronic kidney disease or renal replacement therapy,
• Pregnancy,
• Receiving hospice,
• Not planning to continue to receive hypertension care from NM clinician for the next year,
• Planning to move from the region in the next year,
• Planning to change clinician treating their hypertension in the next year,
• Medical or psychological reason they cannot perform home blood pressure monitoring.
• Known to have average home blood pressure or most recent home blood pressure value of <130/80 mm Hg.

CLINICIAN PARTICIPANT INCLUSION Physician, advanced practice nurse or physician assistant working at a Northwestern Medicine ambulatory primary care site that cares for adults with hypertension (family medicine, internal medicine, medicine/pediatrics, and ambulatory geriatrics sites).

CLINICIAN PARTICIPANT EXCLUSION

• Primary care physicians and clinicians not willing for their patients to participate in study
• Planning to depart NM within the next year
• Not willing to receive patients' out-of-office blood pressure data