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Cardiology

Innovative telehealth program shows promise in addressing health inequities post-stroke

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A team-based remote blood pressure monitoring program, integrated with a comprehensive Telehealth After Stroke Care (TASC) initiative, demonstrates feasibility and potential positive impact on patients’ well-being, particularly in underserved urban settings, according to a study. The study suggests that incorporating patient-reported outcomes (PROs) through an interactive web-based platform is viable.

Inequities in access to healthcare have long been associated with suboptimal medication adherence and blood pressure control, particularly in underserved urban settings.

Conducted over a 3-month period, the study enrolled patients discharged from a Comprehensive Stroke Center who were randomized to either TASC or usual care. Participants were equipped with a blood pressure monitor and a tablet that wirelessly transmitted data to a cloud-based platform, seamlessly integrated with their electronic health records. The study employed various mechanisms for PRO submission, including tablets, phones, tablet with phone coaching, and email, ensuring flexibility for participants.

Of the 50 participants, two-thirds represented Hispanic or non-Hispanic Black individuals. Results indicated that the team-based remote blood pressure monitoring program had a notable impact on patients’ well-being.

The collection of PROs through an interactive web-based platform proved to be feasible, offering valuable insight into patients’ experiences post-stroke. Depressive scores measured by the Patient Health Questionnaire-9 (PHQ-9) were nominally lower in the TASC group at 3 months compared to usual care, suggesting a potential positive effect on psychological distress (2.7 ± 3.6 vs 4.0 ± 4.1; P = 0.06).

Although there were no significant differences observed in other PRO measures such as PROMIS-MMT, Patient Activation Measure, or Neuro-QoL, the overall findings underscore the potential of utilizing technology-enhanced, team-based approaches to bridge gaps in post-stroke care.

Reference
Naqvi IA, Strobino K, Li H, et al. Improving Patient-Reported Outcomes in Stroke Care using Remote Blood Pressure Monitoring and Telehealth. Appl Clin Inform. 2023;14(5):883-891. doi: 10.1055/s-0043-1772679. Epub 2023 Nov 8. PMID: 37940129; PMCID: PMC10632067.

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