• Aditi Gupta, Shellie D Ellis, Crystal Burkhardt, Kate Young, Diego R Mazzotti, Jonathan Mahnken, Noor Abu-El-Rub, Sravani Chandaka, Branden Comfort, Denton Shanks, Jennifer Woodward, Amber Unrein, Heidi Anderson, Jennifer Loucks, Xing Song, Lemuel R Waitman, and Jeffrey M Burns.
• Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
• Fam Pract. 2023 Mar 28; 40 (2): 414422414-422.

IntroductionImplementing a health system-based hypertension programme may lower blood pressure (BP).MethodsWe performed a randomized, controlled pilot study to assess feasibility, acceptability, and safety of a home-based virtual hypertension programme integrating evidence-based strategies to overcome current barriers to BP control. Trained clinical pharmacists staffed the virtual collaborative care clinic (vCCC) to remotely manage hypertension using a BP dashboard and phone "visits" to monitor BP, adherence, side effects of medications, and prescribe anti-hypertensives. Patients with uncontrolled hypertension were identified via electronic health records. Enrolled patients were randomized to either vCCC or usual care for 3 months. We assessed patients' home BP monitoring behaviour, and patients', physicians', and pharmacists' perspectives on feasibility and acceptability of individual programme components.ResultsThirty-one patients (vCCC = 17, usual care = 14) from six physician clinics completed the pilot study. After 3 months, average BP decreased in the vCCC arm (P = 0.01), but not in the control arm (P = 0.45). The vCCC participants measured BP more (9.9 vs. 1.2 per week, P < 0.001). There were no intervention-related adverse events. Participating physicians (n = 6), pharmacists (n = 5), and patients (n = 31) rated all programme components with average scores of >4.0, a pre-specified benchmark. Nine adaptations in vCCC design and delivery were made based on potential barriers to implementing the programme and suggestions.ConclusionA home-based virtual hypertension programme using team-based care, technology, and a logical integration of evidence-based strategies is safe, acceptable, and feasible to intended users. These pilot data support studies to assess the effectiveness of this programme at a larger scale.© The Author(s) 2022. Published by Oxford University Press.

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