Page 6 CirculationCardiovascularQualityandOutcomes

Magid et al Pharmacist-Led, Heart360 Home BP Program 5

Figure 2. Six-month rates and 95% confidence
intervals of blood pressure control for the home
blood pressure monitoring (HBPM) intervention and
the usual care groups. CKD indicates chronic kid-
ney disease; and DM, diabetes mellitus.

the HBPM group also reported paying increased attention study intervention. The mean and median number of BP read-
to their BP (60% versus 40% in the UC group; P<0.001). ings per upload were 7.3 (SD, 8.6) and 5 (25th–75th percen-
Finally, 68% of HBPM patients reported that the home BP tile, 3–9), respectively.
cuff and Heart360 monitoring system were very or extremely
easy to use, and the majority of patients (52%) found their
interactions with the clinical pharmacy specialist to be very Discussion
or extremely helpful. This pragmatic clinical trial of a pharmacist-led, Heart360-
With regard to health care used, the mean number of out- supported HBPM intervention led to higher rates of BP con-
patient clinic visits was similar for the HBPM and UC groups trol and greater BP reductions than UC. The impact of the
(3.3 versus 3.1; P=0.16; Table 3). The total number of emer- intervention on BP control and degree of BP lowering was
gency department visits (6 for HBPM and 9 for UC, P=0.44) even greater among the subset of patients with DM and CKD.
and hospitalizations (5 for HBPM and 7 for UC P=0.57) did Although the intervention required patients to regularly
not differ significantly between the 2 groups. However, com- monitor home BP readings, to upload the readings into the
pared with the UC group, the HBPM group had a higher mean Heart360 Web site, and to have regular contact with a clinical
number of e-mail encounters (6.0 versus 2.4; P<0.001) and pharmacy specialist, most patients found the intervention easy
telephone encounters (5.3 versus 3.5; P=0.02). to use, and HBPM patients reported higher satisfaction with
Overall, 113 of 162 HBPM patients (70%) were adherent their hypertension care than those who received UC. Addi-
to the BP monitoring protocol, uploading their home BP read- tionally, whereas there was no difference between groups in
ings for 80% or more of the weeks during the study interven- clinic, emergency department, or hospital visits, patients in
tion. A total of 156 patients (96%) measured and uploaded the HBPM group had more e-mail and telephone encounters
home BP readings for half or more of the weeks during the than patients in the UC group.

Figure 3. Reduction in systolic and diastolic blood
pressures and 95% confidence intervals for the
home blood pressure monitoring (HBPM) interven-
tion and the usual care groups.

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