PHTI: Some digital hypertension tools effective in reducing BP

Digital hypertension management solutions that use the medication management approach are generally effective, delivering clinically meaningful decreases in systolic blood pressure relative to usual care, according to a new report.

The report, released by the Peterson Health Technology Institute (PHTI), assesses the efficacy of digital hypertension management solutions in improving clinical outcomes and expanding access to timely treatment.

Hypertension, or high blood pressure (BP), is widely prevalent in the United States, with 47.7% of adults age 18 and older suffering from the disease between 2021 and 2023, CDC data shows. However, only one-fifth of these adults (20.7%) had their BP under control.

PHTI examined digital hypertension management solutions from 11 companies: AMC Health, Cadence Design Systems, DarioHealth, Hello Heart, Health Recovery Solutions, Lark Technologies, Ochsner Digital Medicine, Omada Health, Story Health, Teladoc Health and VitalSight. The solutions were divided into three categories based on their approach:

• Blood pressure monitoring solutions that enable home monitoring, transmitting data back to the healthcare provider.
• Medication management solutions that rely on virtual care teams to coordinate medication adjustments in addition to the patient's main primary care team.
• Behavior change solutions that deliver educational content, alerts, reminders and virtual interactions with digital or human coaches and care teams to improve patient self-management.

The organization's researchers assessed clinical effectiveness through a systematic literature review, screening approximately 2,500 pieces of evidence and including 73 articles, abstracts and posters in the analysis. They also studied the economic impact of the solutions over three years.

Digital solutions that used the medication management approach were associated with clinically meaningful decreases in systolic blood pressure (SBP) and brought a greater proportion of patients into BP control than usual care. These solutions also prompted faster improvements in hypertension care outcomes.

Though these solutions increased net health spending in the first three years, the researchers noted that they have the potential to offset costs over a decade because of savings from avoided cardiovascular events.

However, solutions based on BP monitoring and behavior change approaches did not result in clinically meaningful improvements to SBP. They also initially increased net health spending; however, they did not produce the long-term net savings needed to offset the initial expenditure.

Thus, PHTI concluded that digital hypertension solutions using the medication management approach warrant broader adoption.

"Too many people are living with uncontrolled hypertension, but there are effective digital solutions to help patients improve their cardiovascular health, save lives, and lower spending over the long run," said Caroline Pearson, executive director of PHTI, in a news release.

This is PHTI's latest evaluation. The Peterson Center on Healthcare launched the organization to analyze the efficacy of digital health solutions amid accelerating adoption as virtual healthcare moves from volume to value.

In March 2024, PHTI released an evaluation of digital management tools targeting type 2 diabetes, finding they do not provide meaningful clinical benefits.

After examining eight digital tools addressing type 2 diabetes, researchers concluded that improvements in glycemic control resulting from digital diabetes management were minimal and short-term. Additionally, they did not find compelling evidence that these tools mitigate health inequities.

A few months later, in June 2024, PHTI released a report showing that digital solutions targeting musculoskeletal (MSK) disorders can improve pain and function outcomes. Researchers examined eight virtual MSK solutions for the analysis.

The researchers found that not only do the solutions deliver clinically meaningful improvements in pain and function compared to people receiving usual care, but they also reduce average healthcare spending.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.