23-05-2025
Smartphone Monitoring Cuts BP Post-ED Discharge
In a study, patients who received a team-based intervention involving education and mobile health support in the emergency department (ED) had greater reduction in systolic blood pressure (SBP) at 6 months than those who received standard discharge care.
METHODOLOGY:
A randomized clinical trial enrolled 574 adult patients (mean age, 51.1 years) with elevated BP (between 140/90 mm Hg and 180/110 mm Hg) who visited an urban academic ED between February 2019 and March 2023.
Participants were randomly assigned to receive either standard discharge instructions and a primary care referral (n = 285) or a multicomponent education and empowerment intervention (E2; n = 289), which included a brief consultation with a clinical pharmacist and a smartphone-connected BP monitor with behavior change text reminders.
The primary outcome was a mean change in SBP at 6 months.
Secondary outcomes included changes in SBP at 3 months and changes in diastolic BP (DBP) at both 3 and 6 months.
TAKEAWAY:
At 6 months, patients who received the E2 intervention had a greater reduction in SBP than those who received usual care (mean difference, 4.9 mm Hg; P = .02).
= .02). The between-group differences in SBP at 3 months (4.2 mm Hg) and DBP at 6 months (2.3 mm Hg) were not statistically significant.
At 6 months, 42.9% of participants in the E2 group and 36.9% in the usual care group achieved BP levels ≤ 140/90 mm Hg, but this difference was not significant ( P = .22).
IN PRACTICE:
"Results of the TOUCHED randomized clinical trial suggest that a multicomponent Education and Empowerment (E2) intervention initiated in the ED may present a viable and effective strategy for reducing SBP in patients with elevated BP who are discharged from the ED," the authors wrote.
SOURCE:
The study was led by Heather Prendergast, MD, MPH, MS, Department of Emergency Medicine, University of Illinois Chicago. It was published online on April 23, 2025, in JAMA Cardiology .
LIMITATIONS:
Recruitment and follow-up occurred during the COVID-19 pandemic, which could have reduced participation and introduced selection bias. The single-center design limited generalizability. Long-term cardiovascular outcomes were not assessed.
DISCLOSURES:
The study was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health. Several authors reported receiving grants from the National Institutes of Health and/or National Heart, Lung, and Blood Institute during the conduct of the study.
