Patient-Portal vs Text-based Hypertension Monitoring Among Black Medicaid/Medicare Patients

Study Overview
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Brief Summary
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The coronavirus disease 2019 (COVID-19) pandemic has uprooted conventional health care delivery for routine ambulatory care, requiring health systems to rapidly adopt telemedicine capabilities. The digital divide, has been well documented with lower rates of technology and broadband adoption among racial/ethnic minorities. Additionally, Black patients suffer a disproportionate burden of hypertension and cardiovascular disease. This study will implement a text-based home hypertension monitoring program among Black Medicaid patients with hypertension and cardiovascular disease (CVD) and compare its uptake to the currently available blood pressure monitoring program using the patient portal that is integrated into the electronic health record (EHR).

Official Title
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Patient-Portal vs Text-based Hypertension Monitoring Among Black Medicaid/Medicare Patients

Conditions
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Hypertension, Cardiovascular Diseases

Intervention / Treatment
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* Behavioral: Texting
* Behavioral: Online patient portal


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Self-identified Black race Medicaid or Medicare insurance Hypertension Cardiovascular disease or presence of at least 1 cardiovascular risk factor Seen for in-person consultation at the Heart and Vascular clinic at the Hospital of the University of Pennsylvania Exclusion Criteria: Does not speak English Already owns a BP cuff Does not have internet access or a phone 15 with texting capabilities

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Text-based monitoring<br>Patients will be asked to take their BP two times daily and text their BP to the study phone number twice a day for 14 days. | Behavioral: Texting<br>* Patients will be asked to text their BP. They will receive an automated response to their texts.<br>|
| Active Comparator: Online patient portal<br>Patients will be asked to take their BP two times daily. They will be given instructions on how to upload BP readings to the online patient portal and will be asked to upload all BP readings. This represents enhanced standard of care. | Behavioral: Online patient portal<br>* Patients will be asked to upload their BP to the online patient portal. They will receive information on how to sign up and use the patient portal. Patients can upload their BP readings daily or at the end of the study period.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of BP measurements reported | Number of BP results reported over the study period | 14 days | 
| Proportion of patients submitting 1 or more BP measurement | Proportion of patients per study arm reporting at least one BP measurement | 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction | Patients will be asked to complete a survey about ease of use and likelihood of recommending the intervention | Within 2 weeks of end of study period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Racial disparities, Digital technology, Hypertension