Deborah Brauser

June 23, 2016

PARIS, FRANCE — Working in tandem with a home-based, wireless blood-pressure (BP) monitor, new software is easy for patients to use and understand, increases measurement compliance, and helps to improve communication with healthcare providers, new research suggests[1].

The Hy-Result software, for use with computers and mobile devices, was created to help patients "to comply with blood-pressure–measurement protocols and to correctly interpret their results," Dr Nicolas Postel-Vinay (Hôpital Européen Georges-Pompidou, Paris, France) told attendees at a late-breaking clinical-trial session here at the European Society of Hypertension (ESH) 2016 Annual Meeting.

After a patient enters his or her medical profile and self-measured BP readings, the software checks the data and then "calculates the overall mean of all systolic and diastolic BP measurements and the means for morning and evening measurements to produce a graph representing the daily mean," explained Postel-Vinay.

This information is then automatically sent to the patient via text message and is also available as a PDF-formatted report that can be printed out and stored and/or shared with a physician.

Results from a user-perception study, based on returned questionnaires from more than 200 hypertensive patients in the US and UK, showed that 95% found the text messages easy or very easy to understand, 85% said the software helped in understanding their BP readings, and 80% "agreed that the recommendations given by Hy-Result are adapted to their situation." In addition, 67% said the software would be helpful when talking with clinicians about their BP values.

Dr Nicolas Postel-Vinay

"The main point is that the majority of these patients found this system useful," Postel-Vinay told heartwire from Medscape.

"The future is on patient employment and not only with face-to-face doctor visits. With this software, we're pushing the patient to the doctor only if they are clearly in the 'red zone,' or at high risk," he said. "If it's shown that they're in the green zone, then we say it's not needed to see the doctor now."

Evaluating Satisfaction, Comprehension

Findings from an earlier validation study "conducted in a daily routine care setting" were published earlier this year in Blood Pressure Monitoring[2]. But Postel-Vinay said the investigators also wanted to examine user satisfaction and comprehension of the software.

For the new analysis, the manufacturer of the Withings BP 800 wireless BP monitor sent out 3000 questionnaires in March 2016. These were randomly administered to users of the Hy-Result software within the Health Mate mobile app, which is connected with the BP 800. Of this potential study population, only 7.6% (n=228) responded to the 24-question anonymous questionnaires.

"This was a low response rate, but it's not all that unusual in primary care," noted Postel-Vinay. He added that although the software currently works only with the Withings products, there are ongoing discussions with other manufacturers. "We are totally independent of Withings," he pointed out.

In addition to the results already mentioned, 79% of the respondents said it was easy or very easy to access the PDF report function, 88% said the measurement reminder function was "useful," and 69% opted in to use the system's calendar reminder to recheck their BP 3 to 4 months later.

Only 23% of the patients shared their PDF report with their physicians, but of these, 73% said their physician thought it was a useful tool; 26% of the other physicians didn't look at the report. And one actually advised against using the software.

A total of 75% of all participants said they'll continue using the software vs 15% who weren't sure and 10% who said they planned to stop use; 61% said they'll recommend its use to their families.

Additional Research

Because the study population already owned a connected device and was relatively young (mean age 48 years), the investigators worried about responder bias, said Postel Vinay. "Are these Hy-Result users representative of the hypertensive populations? Probably not," he said. "So the survey continued in medical-care settings."

Very preliminary results from that survey study, which included 62 responders in France and Belgium, closely matched most of the earlier study's results: 96% found the text messages easy or very easy to understand, 86% said it was easy to send results through the PDF report, and 82% said the software helped them understand their BP readings.

More did say that the software will help with talking with their doctor (82% vs 67%), but slightly fewer said they'd continue using Hy-Result (68% vs 75%), while 22% said they weren't sure. Again, only 10% said they'd stop use.

Postel-Vinay said that more results from this latter study, which will also include data from users in Canada and Spain, will be released in a few months. For now, he said the overall findings show that the software is "an appropriate tool for self-care." But he stressed that "our algorithm isn't a substitute for medical advice."

"Has Potential"

"This was interesting. Although the response rate was small, these were nice results anyway," said session moderator Dr Eivind Berge (Oslo University Hospital, Norway) to heartwire .

"The responders, even though they were few, definitely thought this was a good way of monitoring blood pressure. It was a good method."

Berge noted that the PDF report, especially, sounded helpful for clinicians. "It produces nice graphs that we can see over time. And it could even be time-saving if these reports could be sent over before or even instead of an appointment," he said. "Definitely I think this is a method that has potential."

The study was funded by the Claude Bernard Association for Medical Research. Postel-Vinay reports "competing interests" with Automesure and Withings. He also helped develop the HyResult software and website. Berge reported no relevant financial relationships.

Follow Deborah Brauser on Twitter: @heartwireDeb. For more from theheart.org, follow us on Twitter and Facebook.

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