Remote Patient Monitoring of Blood Pressure Is Feasible Poststroke and Can Facilitate Triage of Care

Jenna M Tosto-Mancuso; David Putrino; Jamie Wood; Laura Tabacof; Erica Breyman; Leila Nasr; Nicki Mohammadi; Neha S Dangayach; Christopher P Kellner

doi:10.1089/tmr.2022.0004

Remote Patient Monitoring of Blood Pressure Is Feasible Poststroke and Can Facilitate Triage of Care

Telemed Rep. 2022 Aug 2;3(1):149-155. doi: 10.1089/tmr.2022.0004. eCollection 2022.

Authors

Jenna M Tosto-Mancuso¹, David Putrino¹, Jamie Wood¹, Laura Tabacof¹, Erica Breyman¹, Leila Nasr¹, Nicki Mohammadi², Neha S Dangayach², Christopher P Kellner²

Affiliations

¹ Department of Rehabilitation and Human Performance and Icahn School of Medicine at Mount Sinai, New York, New York, USA.
² Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Abstract

Background and purpose: Strict blood pressure (BP) control is a universally accepted therapeutic intervention in the prevention of secondary stroke, yet this remains difficult when patients return home postinjury. This study aimed to investigate the application of the remote patient monitoring (RPM) of BP in patients after stroke, or who were at immediate risk of stroke, and the subsequent outcomes relating to triage and escalation of care.

Methods: This was a single-center proof-of-concept study. Participants were patients aged 18 years and older with a diagnosis of stroke or who were at immediate risk of stroke. Patients were enrolled into the precision recovery program (PRP) and asked to assess their BP and heart rate daily and enter values into a MyCap application for the RPM program. These data were reviewed daily by an assigned PRP clinician, and weekly Zoom meetings were held with the patient. Care was triaged and escalated to a physician as indicated.

Results: Twelve patients (5 [42%] female, aged mean [range] 63 [43-84] years) met the inclusion criteria and continued in the program for median (range) 136 (8-227) days. The median (range) number of excursions of BP above limits per participant was 19 (0-79) for systolic and 36 (0-104) for diastolic. A total of 16 triage events (median [range] 1 [0-3]) were initiated for escalation of care.

Conclusions: This study demonstrated that RPM is feasible in patients poststroke or at immediate risk of stroke, and facilitates the triage of care when BP is elevated above recommended limits.

Keywords: blood pressure; mHealth; remote monitoring; stroke; telehealth.