TY - JOUR
T1 - Associations between remote patient monitoring and uncontrolled blood pressure among patients diagnosed with hypertension
T2 - Exploring variations by race/ethnicity
AU - Meddar, John M.
AU - Mann, Devin
AU - Schwartz, Mark
AU - Park, Hyung G.
AU - Engelberg, Rachel
AU - Khan, Maria R.
N1 - Publisher Copyright:
© 2025 Meddar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/11
Y1 - 2025/11
N2 - Background Hypertension (HTN) is a critical public health concern that disproportionately impacts racial/ethnic minorities. The recent COVID-19 pandemic spurred rapid adoption of virtual HTN treatment programs such as remote patient monitoring programs (RPM), including among minority populations. However, it is unclear how utilization patterns differ across racial/ethnic groups and what the implications are for HTN outcomes. Objective The present study examines whether the association between RPM utilization and uncontrolled BP differs by race/ethnicity among hypertensive patients enrolled in an RPM program. Methods This study includes an urban sample of HTN patients who were 18≥years old who have been in their RPM programs for three consecutive months or longer. Our primary exposure measures are three widely used dichotomized RPM engagement metrics and uncontrolled BP outcomes were dichotomized as BP≥140/90 and ≥ 130/80. We tested for effect modification by race/ethnicity across RPM utilization variables using multivariable logistic regression models. Results Of 2920 participants, 59% were females, 37% were≥65 years old, and Hispanic patients were the most represented race/ethnicity group (39%). Percentage-uncontrolled was 25% non-Hispanic Black, 21% Hispanic, and 20% among non-Hispanic White patients. Compared to non-Hispanic White patients with high RPM utilization, patients with no BP transmission had higher odds of uncontrolled BP: White (OR=1.72; 95% CI: 1.07–2.75), Black (OR=2.11; 95% CI: 1.32–3.39), and Other race (OR=2.36; 95% CI: 1.41–3.96). Similar patterns were observed for low clinician interactions and low portal use. Conclusion Disparities in RPM utilization and BP outcomes in our study parallel reported inequities in digital technology utilization and uncontrolled BP in the U.S. Future studies should aim to understand how utilization trends among various vulnerable populations influence HTN outcomes. Such findings may help inform efforts aimed at streamlining access and utilization of RPM to reduce utilization disparities and promote better BP control.
AB - Background Hypertension (HTN) is a critical public health concern that disproportionately impacts racial/ethnic minorities. The recent COVID-19 pandemic spurred rapid adoption of virtual HTN treatment programs such as remote patient monitoring programs (RPM), including among minority populations. However, it is unclear how utilization patterns differ across racial/ethnic groups and what the implications are for HTN outcomes. Objective The present study examines whether the association between RPM utilization and uncontrolled BP differs by race/ethnicity among hypertensive patients enrolled in an RPM program. Methods This study includes an urban sample of HTN patients who were 18≥years old who have been in their RPM programs for three consecutive months or longer. Our primary exposure measures are three widely used dichotomized RPM engagement metrics and uncontrolled BP outcomes were dichotomized as BP≥140/90 and ≥ 130/80. We tested for effect modification by race/ethnicity across RPM utilization variables using multivariable logistic regression models. Results Of 2920 participants, 59% were females, 37% were≥65 years old, and Hispanic patients were the most represented race/ethnicity group (39%). Percentage-uncontrolled was 25% non-Hispanic Black, 21% Hispanic, and 20% among non-Hispanic White patients. Compared to non-Hispanic White patients with high RPM utilization, patients with no BP transmission had higher odds of uncontrolled BP: White (OR=1.72; 95% CI: 1.07–2.75), Black (OR=2.11; 95% CI: 1.32–3.39), and Other race (OR=2.36; 95% CI: 1.41–3.96). Similar patterns were observed for low clinician interactions and low portal use. Conclusion Disparities in RPM utilization and BP outcomes in our study parallel reported inequities in digital technology utilization and uncontrolled BP in the U.S. Future studies should aim to understand how utilization trends among various vulnerable populations influence HTN outcomes. Such findings may help inform efforts aimed at streamlining access and utilization of RPM to reduce utilization disparities and promote better BP control.
UR - https://www.scopus.com/pages/publications/105021068097
U2 - 10.1371/journal.pone.0334887
DO - 10.1371/journal.pone.0334887
M3 - Article
C2 - 41196914
AN - SCOPUS:105021068097
SN - 1932-6203
VL - 20
JO - PLoS ONE
JF - PLoS ONE
IS - 11 November
M1 - e0334887
ER -