Evidence map›Paper›PMID 34106085›Full record

ArticleJMIR research protocols2021

Wireless Home Blood Pressure Monitoring System With Automatic Outcome-Based Feedback and Financial Incentives to Improve Blood Pressure in People With Hypertension: Protocol for a Randomized Controlled Trial.

Marcel Bilger, Agnes Ying Leng Koong, Ian Kwong Yun Phoon, Ngiap Chuan Tan, Juliana Bahadin, Joann Bairavi, Ada Portia M Batcagan-Abueg, Eric A Finkelstein

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in JMIR research protocols, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03368417 (A Randomised Controlled Trial to Improve Hypertension Outcomes Using Wireless Home Blood Pressure Monitoring With Automatic Outcome-based Feedback and Financial Incentives), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 95% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03368417 naterminatednot on this map

A Randomised Controlled Trial to Improve Hypertension Outcomes Using Wireless Home Blood Pressure Monitoring With Automatic Outcome-based Feedback and Financial Incentives

TypeinterventionalSponsorDuke-NUS Graduate Medical SchoolRan2017 to 2019Enrolled42ConditionsHypertensionArmsUsual Care, Wireless HBPM System, BP Monitoring Incentives
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Selection and reporting of usual care comparators when designing primary care trials of complex health interventions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Marcel BilgerHealth Economics and Policy, Vienna University of Economics and Business, Vienna, Austria, Austria.ORCID https://orcid.org/0000-0002-2872-6597
Agnes Ying Leng KoongSingHealth Polyclinics, Singapore, Singapore.ORCID https://orcid.org/0000-0002-5968-1918
Ian Kwong Yun PhoonSingHealth Polyclinics, Singapore, Singapore.ORCID https://orcid.org/0000-0002-3049-3745
Ngiap Chuan TanSingHealth Polyclinics, Singapore, Singapore.ORCID https://orcid.org/0000-0002-5946-1149
Juliana BahadinSaudara Clinic by A+J General Physicians, Singapore, Singapore.ORCID https://orcid.org/0000-0003-4590-4620
Joann BairaviHeath Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.ORCID https://orcid.org/0000-0001-9497-3994
Ada Portia M Batcagan-AbuegHeath Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.ORCID https://orcid.org/0000-0001-6114-3257
Eric A FinkelsteinHeath Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.ORCID https://orcid.org/0000-0001-6443-9686
SingHealth Polyclinics · SGDuke-NUS Medical School · SGDuke University · USSaluda Medical (Australia) · AUVienna University of Economics and Business · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension is prevalent in Singapore and is a major risk factor for cardiovascular morbidity and mortality and increased health care costs. Strategies to lower blood pressure include lifestyle modifications and home blood pressure monitoring. Nonetheless, adherence to home blood pressure monitoring remains low. This protocol details an algorithm for remote management of primary care patients with hypertension.

objectiveThe objective of this study was to determine whether wireless home blood pressure monitoring with or without financial incentives is more effective at reducing systolic blood pressure than nonwireless home blood pressure monitoring (usual care).

methodsThis study was designed as a randomized controlled open-label superiority study. A sample size of 224 was required to detect differences of 10 mmHg in average systolic blood pressure. Participants were to be randomized, in the ratio of 2:3:3, into 1 of 3 parallel study arms :(1) usual care, (2) wireless home blood pressure monitoring, and (3) wireless home blood pressure monitoring with financial incentives. The primary outcome was the mean change in systolic blood pressure at month 6. The secondary outcomes were the mean reduction in diastolic blood pressure, cost of financial incentives, time taken for the intervention, adherence to home blood pressure monitoring, effectiveness of the framing of financial incentives in decreasing nonadherence to blood pressure self-monitoring and the adherence to antihypertensive medication at month 6.

resultsThis study was approved by SingHealth Centralised Institutional Review Board and registered. Between January 24, 2018 and July 10, 2018, 42 participants (18.75% of the required sample size) were enrolled, and 33 participants completed the month 6 assessment by January 31, 2019.

conclusionsDue to unforeseen events, the study was stopped prematurely; therefore, no results are available. Depending on the blood pressure information received from the patients, the algorithm can trigger immediate blood pressure advice (eg, Accident and Emergency department visit advice for extremely high blood pressure), weekly feedback on blood pressure monitoring, medication titration, or skipping of routine follow-ups. The inclusion of financial incentives framed as health capital provides a novel idea on how to promote adherence to remote monitoring, and ultimately, improve chronic disease management.

trial registrationClinicalTrials.gov NCT03368417; https://clinicaltrials.gov/ct2/show/NCT03368417. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/27496.

Indexed as

behavior changefinancial incentivehome blood pressure monitoringhypertensionmedication adherenceremote titrationtelemedicine

Identifiers

PMID34106085
PMCPMC8262550
OpenAlexW3145986338

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.