Cloud-based BP system integrated with CPOE improves self-management of the hypertensive patients: A randomized controlled trial

Peisan Lee; Ju-Chi Liu; Ming-Hsiung Hsieh; Wen-Rui Hao; Yuan-Teng Tseng; Shuen-Hsin Liu; Yung-Kuo Lin; Li-Chin Sung; Jen-Hung Huang; Hung-Yu Yang; Jong-Shiuan Ye; He-Shun Zheng; Min-Huei Hsu; Shabbir Syed-Abdul; Richard Lu; Phung-Anh Nguyen; Usman Iqbal; Chih-Wei Huang; Wen-Shan Jian; Yu-Chuan Jack Li

doi:10.1016/j.cmpb.2016.04.003

Cloud-based BP system integrated with CPOE improves self-management of the hypertensive patients: A randomized controlled trial

Comput Methods Programs Biomed. 2016 Aug:132:105-13. doi: 10.1016/j.cmpb.2016.04.003. Epub 2016 Apr 7.

Authors

Peisan Lee¹, Ju-Chi Liu², Ming-Hsiung Hsieh³, Wen-Rui Hao⁴, Yuan-Teng Tseng⁵, Shuen-Hsin Liu⁴, Yung-Kuo Lin³, Li-Chin Sung⁴, Jen-Hung Huang³, Hung-Yu Yang³, Jong-Shiuan Ye³, He-Shun Zheng³, Min-Huei Hsu⁶, Shabbir Syed-Abdul⁷, Richard Lu⁷, Phung-Anh Nguyen⁷, Usman Iqbal⁸, Chih-Wei Huang⁷, Wen-Shan Jian⁹, Yu-Chuan Jack Li¹⁰

Affiliations

¹ Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
² Division of Cardiology, Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan.
³ Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
⁴ Department of Cardiovascular Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
⁵ Department of Cardiovascular Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Saint Mary's Hospital Loudong, Loudong, Taiwan.
⁶ College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Office of International Cooperation, Ministry of Health and Welfare, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan.
⁷ College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan.
⁸ College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan; Health Informatics Department, COMSATS Institute of Information Technology, Islamabad, Pakistan.
⁹ College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Faculty of Health Sciences, Macau University of Science and Technology, Macau.
¹⁰ College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan; Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address: jack@tmu.edu.tw.

PMID: 27282232
DOI: 10.1016/j.cmpb.2016.04.003

Abstract

Background: Less than 50% of patients with hypertensive disease manage to maintain their blood pressure (BP) within normal levels.

Objective: The aim of this study is to evaluate whether cloud BP system integrated with computerized physician order entry (CPOE) can improve BP management as compared with traditional care.

Methods: A randomized controlled trial done on a random sample of 382 adults recruited from 786 patients who had been diagnosed with hypertension and receiving treatment for hypertension in two district hospitals in the north of Taiwan. Physicians had access to cloud BP data from CPOE. Neither patients nor physicians were blinded to group assignment. The study was conducted over a period of seven months.

Results: At baseline, the enrollees were 50% male with a mean (SD) age of 58.18 (10.83) years. The mean sitting BP of both arms was no different. The proportion of patients with BP control at two, four and six months was significantly greater in the intervention group than in the control group. The average capture rates of blood pressure in the intervention group were also significantly higher than the control group in all three check-points.

Conclusions: Cloud-based BP system integrated with CPOE at the point of care achieved better BP control compared to traditional care. This system does not require any technical skills and is therefore suitable for every age group. The praise and assurance to the patients from the physicians after reviewing the Cloud BP records positively reinforced both BP measuring and medication adherence behaviors.

Keywords: CPOE; Cloud-based BP system; Hypertension; Randomized controlled trial; Self-management.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Blood Pressure Monitoring, Ambulatory / methods*
Blood Pressure Monitoring, Ambulatory / standards
Cloud Computing*
Female
Humans
Hypertension / therapy*
Male
Middle Aged
Self Care*
Systems Integration*