Cloud-based BP system integrated with CPOE improves self-management of the hypertensive patients: A randomized controlled trial.
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.
Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
Peisan
P
Lee
Division of Cardiology, Department of Internal Medicine, Taipei Medical University, Taipei, Taiwan.
Ju-Chi
JC
Liu
Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
Ming-Hsiung
MH
Hsieh
Department of Cardiovascular Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Wen-Rui
WR
Hao
Department of Cardiovascular Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Saint Mary's Hospital Loudong, Loudong, Taiwan.
Yuan-Teng
YT
Tseng
Department of Cardiovascular Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Shuen-Hsin
SH
Liu
Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
Yung-Kuo
YK
Lin
Department of Cardiovascular Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Li-Chin
LC
Sung
Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
Jen-Hung
JH
Huang
Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
Hung-Yu
HY
Yang
Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
Jong-Shiuan
JS
Ye
Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.
He-Shun
HS
Zheng
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.
Min-Huei
MH
Hsu
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.
Shabbir
S
Syed-Abdul
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.
Richard
R
Lu
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.
Phung-Anh
PA
Nguyen
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.
Usman
U
Iqbal
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.
Chih-Wei
CW
Huang
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.
Wen-Shan
WS
Jian
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.
Yu-Chuan Jack
YC
Li
D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods* / Q000592:standards; D000067917:Cloud Computing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012648:Self Care; D018511:Systems Integration
CPOE; Cloud-based BP system; Hypertension; Randomized controlled trial; Self-management