Results Summary

What was the research about?

Uncontrolled blood pressure, or BP, affects tens of millions of Americans. Lowering BP to recommended levels can reduce the risk of heart attack and stroke. Support from a medical team can help patients lower their BP, but questions remain about the best way to provide care.

In this study, the research team compared two ways of providing care:

  • Clinic-based care, or CBC. In this group, patients had regular, in-person visits with a doctor or medical assistant.
  • Telehealth. In this group, patients received home-based and telephone care from pharmacists or nurse practitioners who had special training to manage patients’ medicines.

What were the results?

After one year, the two groups didn’t differ in how much their BP changed. Both groups had lower BP.

After six months, compared with CBC, patients in the telehealth group:

  • Were more satisfied with their care
  • Reported that visits by phone were more convenient

The two groups didn’t differ in their confidence in self-care or side effects from BP medicine.

Who was in the study?

The study included 3,071 patients with uncontrolled BP. All received care at one of 21 clinics in Minnesota and Wisconsin. Among patients, 69 percent were White, 19 percent were Black, 7 percent were Asian, 1 percent were American Indian/Alaska Native, and 4 percent were another race; 2 percent were Hispanic. The average age was 60, and 53 percent were women.

What did the research team do?

The research team assigned 21 clinics by chance to one of the two groups. In CBC, patients had a BP checkup with a medical assistant in the clinic within two to four weeks. Patients then had regular, in-person follow-up visits until their BP was controlled.

In the telehealth group, doctors referred patients to have a one-hour, in-person visit within two to four weeks. At the visit, patients learned how to measure their BP. Patients then measured their BP at home six times per week. Pharmacists or nurse practitioners received a report with patients’ BP every two weeks and also got alerts if BP was too high or too low. Patients had regular visits with pharmacists or nurse practitioners by phone about how to make medicine and lifestyle changes.

The research team looked at patient BP at the start of the study and again 12 months later. Patients took surveys about their care at the start of the study and again 6 months later.

Patients, doctors, and health system administrators gave input during the study.

What were the limits of the study?

In both groups, only one in three patients had their follow-up visit within two to four weeks as planned. Also, in the telehealth group, pharmacists and nurse practitioners managed patients’ care. Results may have differed if more timely follow-up visits had occurred or if doctors or nurses had managed telehealth care.

Future research could examine telehealth care managed by other clinicians.

How can people use the results?

Patients and doctors can use the results when considering ways to help manage uncontrolled BP.

Final Research Report

This project's final research report is expected to be available by September 2023.

More to Explore...

Videos

Helping Patients Better Control High Blood Pressure
Principal Investigator Karen Margolis speaks about this study, which is comparing two methods of monitoring high blood pressure to determine whether telehealth offers an edge over more traditional clinic-based care.

More Telehealth Research Needed
Principal Investigator Karen Margolis says more research is needed to determine whether telehealth offers an advantage to patients as it becomes more widely available.

Peer-Review Summary

The Peer-Review Summary for this project will be posted here soon.

Conflict of Interest Disclosures

Project Information

Karen L. Margolis, MD, MPH
HealthPartners Institute
$6,021,508
Pragmatic Trial Comparing Telehealth Care and Optimized Clinic-Based Care for Uncontrolled High Blood Pressure

Key Dates

April 2016
January 2023
2016
2022

Study Registration Information

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Last updated: January 20, 2023