Telehealth for Emergency-Community Continuity of Care Connectivity via Home Blood Pressure Telemonitoring (TEC4HOME-BP)

Hypertension (high blood pressure) is the leading cause of death and disability globally and is the most common reason for physician and emergency department (ED) visits in Canada. We are now facing the lowest rates of hypertension treatment and management in more than a decade. Currently, about 1 in 5 Canadian adults have hypertension, of which, about 1 in 3 people do not have their blood pressure (BP) under control. Lowering BP levels by a small amount, can dramatically reduce risk of heart attacks by 20%, stroke by 35%, and heart failure by 40%. Emergency Departments (ED) are a convenient locations to screen for hypertension as everyone gets their BP checked. However, many care providers do not know that high BP in the ED can predict those who actually have a diagnosis of hypertension or cardiovascular disease. Although guidelines recommend close follow up for these individuals, in reality follow up and monitoring of BP after discharge from the ED is inconsistent and fragmented. Hypertension is one of the chronic diseases that can be managed effectively at home, through use of digital health technology. During the global COVID-19 pandemic, there was a significant increase in the use of virtual health. This represents an opportunity to use digital health tools for home BP telemonitoring, and integration in hypertension clinical practice. Use of digital health tools can significantly improve self-management, medication adherence, patient engagement, and BP control. Our study is to better understand if digital health tools, including home BP telemonitoring combined with pharmacist led adjustment in medications can improve BP control compared to usual care in people who have high BP in the ED. The study's results could also streamline how patients with hypertension transition through ED, reduce the length of their stay in hospital and improve their overall safety and quality of care.