Person-centred hypertension care using health information technology

Bakgrund:

Hypertension is one of the most important risk factors for myocardial infarction, stroke, and chronic kidney disease. Still only 13.8% of adults worldwide have their blood pressure controlled. Despite guidelines and effective medication, less than half of the patients treated, reach target blood pressure.

A person-centred care using modern information technology may be an opportunity to achieve better treatment results. We have developed and pilot-tested interactive mobile phone-based system consisting of: • A platform for self-reporting via mobile phone of blood pressure, symptoms, adherence,side effects,

life style and well-being as well as individual reminders and messages for better living • A blood pressure device • A web-based feedback system that graphically shows self-reported data Målsättning: To evaluate the effect of the system in a randomized controlled study in primary care by: • Testing if more patients achieve target blood pressure <140/90 mmHg

• Analyzing the relationship between patients' daily home blood pressure and self-reported stress, physical activity, quality of life, symptoms, drug intake and side effects • Analyzing daily variations in blood pressure and the importance of variation for quality of life • Evaluate the risk of chronic kidney disease inrelation to blood pressure

• Evaluate risk assessment and self-reported health • Evaluating patients' and health professionals' experiences after using the system • Health economic evaluation of cost-effectiveness of the intervention through a model study. Arbetsplan: The system will be evaluated at 32 health care centers in Skåne, Västra Götaland, Jönköping and

Östergötland. 900 patients (450 in active group and 450 in control group) will answer questionnaires, laboratory tests and followup surveys during 1-year. Thereafter we will collect data on morbidity and treatment. Betydelse:

By improving treatment of hypertension, we hope to subsequently decrease complications and morbidity due to hypertension and thereby hospitalization and health care costs. We will be able to investigate the interplay between monitoring BP by a self-monitoring system and the progression of kidney disease.

Due to the generic nature of the technology involved, the self-management system can easily be adapted to monitor other conditions. Conditions suitable for such interventions are e.g. blood glucose and well-being in diabetes, peak expiratory flow in asthma etc.