Effectiveness of remote monitoring for patients with a high risk of cardiovascular disease
a 12-month matched cohort study in primary care
Nicoline E. Van Hattem (Leiden University Medical Center)
Margot M. Rakers (Leiden University Medical Center)
Eric G. Hiddink (Leiden University Medical Center, Stichting Health Base)
Saskia Le Cessie (Leiden University Medical Center)
Just A.H. Eekhof (Leiden University Medical Center)
Frank Den Heijer (Leiden University Medical Center)
Niels H. Chavannes (Leiden University Medical Center)
Hendrikus J.A. Van Os (Leiden University Medical Center)
Douwe E. Atsma (Leiden University Medical Center, TU Delft - DesIgning Value in Ecosystems)
Tobias N. Bonten (Leiden University Medical Center)
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Abstract
Aims
This study aimed to evaluate the effect of remote monitoring using the Cardiovascular Risk Management (CVRM)-Box on blood pressure control, weight management, medication prescriptions, and consultation frequency in primary care patients at high risk of cardiovascular disease (CVD).
Methods and results
In this matched cohort study, patients with a > 5% 10-year CVD mortality risk in primary care (2020–2024) were compared to propensity score-matched controls over 12 months. The CVRM-Box included smartphone-connected devices (blood pressure monitor, weighing scale, activity tracker) linked to general practitioner electronic health records.
Compared to controls, the intervention group showed modest reductions in office-measured systolic {−1.1 mmHg [95% confidence interval (CI), −3.7 to −1.5]; P = 0.39} and diastolic blood pressure [−0.04 mmHg (95% CI, −1.6 to 1.5); P = 0.96]. Sensitivity analyses yielded similar results. However, CVRM-Box assessments showed reductions in systolic [−5.5 mmHg (95% CI, −7.6 to −3.3); P < 0.001] and diastolic blood pressure [−3.8 mmHg (95% CI, −5.1 to −2.4); P < 0.001]. The intervention group also experienced greater reductions in weight [−0.9 kg (95% CI, −1.6 to −0.2); P = 0.01] and body mass index [−0.3 kg/m² (95% CI, −0.5 to −0.01); P = 0.007]. Additionally, antihypertensive medication use increased [0.12 (95% CI, 0.06 to 0.23); P = 0.04], while consultation frequency decreased (rate ratio 0.82; P = 0.002).
Conclusion
While office measurements showed no additional blood pressure reduction, CVRM-Box measurements demonstrated significant decreases. The intervention also improved target blood pressure achievement, promoted weight reduction, increased antihypertensive use, and reduced consultation frequency.
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