Stroke: Telehealth care after stroke, home remote monitoring of blood pressure is beneficial for blood pressure management

Hypertension is the most important controllable risk factor for stroke, but blood pressure (BP) remains poorly
controlled after stroke.
Recently, some scholars have tested the feasibility of TASC (Telehealth After Stroke Care), a model
of post-acute stroke care that integrates nurse-supported remote monitoring of blood pressure at home, customized infographics, and video visits by multidisciplinary teams.
The results were published in the
journal STROKE.

Patients with acute stroke with hypertension are randomly assigned to usual care or usual care with TASC
upon discharge.
General care patients receive video interviews
for primary care and stroke.
TASC includes a tablet and display that wirelessly transmits blood pressure data to an electronic health record, with remote care support, an infographic with targeted interpretation of blood pressure readings, and pharmacist visits
.
Results assessment was blinded
.
Systolic blood pressure was assessed
from baseline to 3 months after discharge using a generalized linear model.

Results A total of 50 patients (64± 14 years old; 36% were female, 44% Hispanic, 32% black, 54% had a high school education, and 30% were privately insured), and 75% of eligible people were enrolled
in 6.
3 months.
Baseline systolic blood pressure was similar (TASC n=25,140±19 mm Hg; Usual care n = 25,142±19 mm Hg).

After 3 months, TASC had higher
video interview adherence rates (91% vs.
75%, P=0.
14) and retention rates (84% vs.
64%, P=0.
11).
In TASC, family systolic blood pressure decreased by 16±19 mmHg from baseline and increased by 3±24 mmHg (P = 0.
01)
in usual care.
In black patients, systolic blood pressure control (< 130 mm Hg) improved from 40% to 100% in TASC, from 23% to 62% in TASC in Hispanic patients, and from 33% to 17%
in usual care.

In summary, enhanced post-acute stroke care through remote home blood pressure monitoring is feasible to improve hypertension in underserved settings and should be tested
in a well-defined randomised clinical trial.

References:

Telehealth After Stroke Care Pilot Randomized Trial of Home Blood Pressure Telemonitoring in an Underserved Setting