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On November 11, 2022, we reviewed a cohort study published in JAMA Cardiology that implemented and evaluated a remote hypertension (HTN) and cholesterol management program across a diverse health care network.
Researchers recruited 10 803 participants aged between 26-80 years with blood pressure (BP) and/or cholesterol above guideline-recommended targets. Patient navigators were the primary point of contact with participants, responsible for all communications, collecting data, and conveying all recommendations made by the clinical team (eg, on diet, lifestyle, medication) in an effort to optimize risk reduction for adults. Participants received relevant education, integration of a home BP device, and guidance on medication titration from the patient navigator team.
Among the participants in the HTN program who participated in remote medication management, the mean clinic SBP/DBP 6 months after enrollment decreased by 8.7/3.8 mm Hg and by 9.7/5.2 mm Hg at 12 months. Corresponding changes seen in the education-only group were a mean −1.5/−0.7 mm Hg at 6 months and +0.2/−1.9 mm Hg at 12 months (P <.001 for between cohort difference).
In the lipids program, patients who chose to receive remote medication management experienced a mean reduction in LDL-C of 35.4 mg/dL at 6 months and of 37.5 mg/dL at 12 months. Among those in the education-only cohort, mean reductions in LDL-C were 9.3 mg/dL and 10.2 mg/dL at 6 and 12 months, respectively (P<.001).
"The findings in this study indicated an association between remote health delivery at scale and improvements in chronic disease metrics in a large urban and suburban outpatient cohort and across racial, ethnic, and language populations historically underserved by health care. We believe that this program may serve as a model for health care professionals and systems aiming to enhance access, patient engagement, and health outcomes."