Reminders Can Increase Adherence To Home Blood Pressure Monitoring

Dr. Linnea A. Polgreen, Ph.D. Assistant Professor, Health Services Research Department of Internal Medicine, University of Iowa Coralville, Interview with:
Dr. Linnea A. Polgreen, Ph.D.
Assistant Professor, Health Services Research
Department of Pharmacy Practice and Science
Iowa City, IA

Medical Research: What is the background for this study? What are the main findings?

Dr. Polgreen: Many patients with hypertension are unaware that they have hypertension. Furthermore, a substantial number of patients diagnosed with hypertension are poorly controlled. Unfortunately there is no point-of-care test to diagnose hypertension. For most patients with multiple to moderate hypertension, multiple measurements are needed over time to confirm the diagnosis. This need to obtain multiple measurement often delays the diagnosis of hypertension, and delays potential for changes in therapy for those who are diagnosed but poorly controlled. Patients are routinely reminded to check their blood pressure measurements at home. However, these measurements often do not occur or are not collected in a timely fashion. Recently electronic medical records (EMRs) have built portals for patients to enter data such as blood pressure measurements, but it is unclear how effective these portals will be for diagnosing and treating high blood pressure.We studied 121 patients with at least one high blood pressure measurement in the past year and randomized them to three groups.

  • The first group received text messages to which they were told to reply with their blood pressure measurements.
  • The second group was sent text messages reminding them to enter their blood pressures measurements in the hospital’s EMR portal.
  • The third group was instructed to enter their blood pressure measurements in the EMR portal, but they were not given reminders. Automated messages were sent to each patient in the bi-directional text messaging and EMR+reminder groups twice daily for up to 15 days. For the EMR only group, only 47.8% of patients successfully recorded a total of 14 blood pressure measurements within 15 days. For the EMR + reminder group, this percentage was 81.2%, and for the bi-directional text messaging group, it was 97.7%.

Medical Research: What should clinicians and patients take away from your report?

Dr. Polgreen: Providing patients with electronic medical record portals may not be enough. We found that reminders were very important for increasing the number of blood pressure measurements.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Polgreen: Efforts to incorporate reminder systems can increase adherence to home blood pressure monitoring. Future studies should focus on how reminder systems can help improve control of hypertension.


J Am Soc Hypertens. 2015 May;9(5):375-381. doi: 10.1016/j.jash.2015.01.008. Epub 2015 Jan 21.

Outpatient blood pressure monitoring using bi-directional text messaging.

Anthony CA1, Polgreen LA2, Chounramany J3, Foster ED4, Goerdt CJ5, Miller ML5, Suneja M5, Segre AM6, Carter BL3, Polgreen PM5.

[wysija_form id=”3″] Interview with: Dr. Linnea A. Polgreen, Ph.D. (2015). Reminders Can Increase Adherence To Home Blood Pressure Monitoring