Pioneering research from Edinburgh Napier University has shown the use of telemonitoring provides more reliable results when measuring the blood pressure of patients. Telemonitoring is where the patient measures their blood pressure at home regularly and shares the results with their GP or nurse. It is estimated that rolling-out telemonitoring across the country could cut heart attacks by as much as 12%.

Problem:

High blood pressure is a major cause of death and disability, responsible for 50% of heart attacks and strokes and affecting 1.13 billion (1 in 4) adults worldwide. It is known as the ‘silent killer’ due to it often being without symptoms. As many as 20% of those with high blood pressure are undiagnosed or not treated to target and it takes up a significant amount of clinical time, with 1.2 million appointments annually. Due to the ageing population these numbers continue to grow.

Solution:

The Telescot research programme of telemonitoring trials was a collaboration with the NHS, Edinburgh Napier University and the University of Edinburgh. The research showed that using telemonitoring to measure blood pressure has the potential to reduce stroke incidence by 15% and cardiovascular disease by 10%.

More Accurate Results

It was demonstrated that taking blood pressure readings at home avoids ‘white coat hypertension’ where patients get higher blood pressure due to the medical setting. The effect of ‘white coat hypertension’ meant neither doctor or patient had faith in the readings and because of this both sides were reluctant to increase medication. However, home monitoring provides more reliable results over time, meaning follow-up action can be taken when needed. Another major benefit was that it improved patient understanding of their condition and reduced the number of primary care appointments required.

National Roll-Out

The ‘Scale Up BP’ telemonitoring service was the result of the Telescot trials, providing the tools for remote care delivery for people with high blood pressure. After a successful pilot in Lothian 72 GP practices (80% of those trialled) joined the service, offering BP telemonitoring with primary care support. It is now being rolled out nationally with Scottish Government funding. 

NHS Lothian’s figures show that there was a huge increase in use of the service as a result of Covid-19, from 86 patients enrolled per month in January 2020 to 461 patients enrolled in October 2020. By November 2020, Scale Up BP was being used by 14,464 people in 430 GP practices across 11 of the 15 Scottish health boards. The initiative has now been taken up by 60% of GP practices across Scotland and used by 69,000 patients to date.

Worldwide Impact

The research has helped to change international clinical guidance on telemonitoring for blood pressure, influencing services in the US, Canada, Europe, Asia and Japan. It was also awarded the Clinical Improvement Award: Public Health and Prevention at the UK General Practice Awards in December 2019 and was shortlisted for the prestigious British Medical Journal (BMJ) awards.