Impact of remote monitoring on well-being, therapeutic adherence, and organ damage evaluation in hypertensive patients: the PROSIT study

TL;DR

The PROSIT study found that remote monitoring in hypertensive patients improved medication adherence and led to better heart and kidney outcomes compared to standard care.

Contribution

The study introduces a novel telemedicine approach combining wearable ECG devices and mobile apps for hypertension management.

Findings

Groups using remote monitoring showed significantly higher medication adherence compared to the control group.

Early therapeutic adjustments in monitored groups reduced the number of prescribed antihypertensive medications.

Remote monitoring was associated with reduced cardiac and improved renal parameters after 12 months.

Abstract

The PROSIT (Patient-Reported Outcomes and Smart-Imaging in Telecardiology) study aimed to evaluate the feasibility and potential clinical impact of remote patient monitoring in hypertension management, focusing on medication adherence, therapeutic optimization, and organ damage.

We conducted a prospective single-center, randomized pilot study involving 100 hypertensive Caucasian patients, assigned to three groups: Group A, equipped with a wearable ECG device, and a mobile application reporting vital signs; Group B, using only the mobile app; and Group C (control), standard care. Blood pressure and heart rate were measured with validated devices. Medication adherence was assessed with the validated Medication Adherence Report Scale (MARS-5). Echocardiography and biochemical parameters were evaluated at baseline and after 12 months, including a 6-month washout period without digital support. Patients in Groups A and B showed significantly higher MARS-5 scores, vs. Group C (P = 0.001). Early therapeutic adjustments were more frequent in Groups A and B, leading to a reduction in the number of prescribed antihypertensive medications (median decrease from 2 [2–3] to 1 [0–3], P = 0.001). At follow-up, Group A exhibited a significant reduction in interventricular septum thickness and left ventricular mass (P = 0.01) along with improved renal function (A P = 0.04, B P = 0.02).

This study suggests that telemedicine with remote monitoring may enhance medication adherence and allow early treatment optimization with fewer drugs, accompanied by favorable changes in cardiac and renal parameters. These findings warrant confirmation in larger, multicenter studies.

Graphical Abstract

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