Spacht Wesley Alexandra, Lee Simin Gharib, Varugheese Matthew, Subramaniam Samantha, McPartlin Marian, Tucci Michela R, Scirica Benjamin M
Division of Medicine, Brigham and Women's Hospital, Boston, MA (W.A.S.).
Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.G.L., M.V., S.S., M.M.P., M.T., B.M.S.).
Circ Cardiovasc Qual Outcomes. 2025 Apr;18(4):e010394. doi: 10.1161/CIRCOUTCOMES.123.010394. Epub 2025 Mar 27.
Remote health management programs utilizing evidence-based algorithm-driven virtual care solutions for chronic disease management offer a novel approach to addressing implementation gaps for conditions such as hypertension. However, little is known about how to optimize patient enrollment.
Through structured interviews, we conducted a qualitative analysis of patient and primary care physician attitudes toward enrollment in a remote hypertension management program at Mass General Brigham (Boston, MA). We selectively recruited a sampling of patients who had enrolled, declined, or were eligible for Mass General Brigham's remote hypertension management program, which utilized interdisciplinary teams to implement clinical guideline-based algorithmic management of hypertension. We analyzed the data using thematic analysis to identify common themes related to enrollment and engagement.
Between July and August 2022, we performed 20 patient interviews and 6 provider interviews. Most patient participants were male (n=12) and identified their race and ethnicity as White (n=15). Most provider participants were female (n=4), and all were medical doctors. Six themes related to hypertension care and remote hypertension management programs were identified: (1) strong connections between patients and care teams drive engagement; (2) there is widespread comfort with hybrid care delivery; (3) provider guidance facilitates home blood pressure monitoring; (4) the decision to enroll hinges on provider endorsement; (5) a clearly articulated program structure; and (6) working with trained nonlicensed navigators is an acceptable element of remote hypertension management programs.
Enrollment in remote hypertension management programs depends on several key factors. As in traditional care settings, providers significantly influence patient engagement with remote hypertension programs. Key challenges include nonlicensed navigator training and communication clarity about program structure. Building upon facilitators and addressing core challenges are essential for expansion of innovative hypertension care delivery programs to improve patient outcomes at scale.
利用基于证据的算法驱动虚拟护理解决方案进行慢性病管理的远程健康管理项目，为解决高血压等疾病的实施差距提供了一种新方法。然而，对于如何优化患者招募知之甚少。
通过结构化访谈，我们对患者和初级保健医生对麻省总医院布莱根分院（马萨诸塞州波士顿）远程高血压管理项目招募的态度进行了定性分析。我们有选择地招募了已报名、拒绝或符合麻省总医院布莱根分院远程高血压管理项目资格的患者样本，该项目利用跨学科团队实施基于临床指南的高血压算法管理。我们使用主题分析来分析数据，以确定与招募和参与相关的共同主题。
在2022年7月至8月期间，我们进行了20次患者访谈和6次提供者访谈。大多数患者参与者为男性（n = 12），并将自己的种族和族裔确定为白人（n = 15）。大多数提供者参与者为女性（n = 4），且均为医生。确定了与高血压护理和远程高血压管理项目相关的六个主题：（1）患者与护理团队之间的紧密联系推动参与；（2）对混合护理提供方式普遍感到安心；（3）提供者指导有助于家庭血压监测；（4）报名的决定取决于提供者的认可；（5）明确阐述的项目结构；（6）与经过培训的非执照导航员合作是远程高血压管理项目可接受的要素。
远程高血压管理项目的招募取决于几个关键因素。与传统护理环境一样，提供者对患者参与远程高血压项目有重大影响。关键挑战包括非执照导航员培训以及项目结构的沟通清晰度。基于促进因素并应对核心挑战对于扩大创新型高血压护理提供项目以大规模改善患者结局至关重要。
