Interactive text messaging helps control blood pressure in ED

An intervention that involves informational and reminder text messages, among others, is a feasible approach for managing elevated blood pressure (BP) in the emergency department (ED) setting, as reported in a study.

The study included 206 adult patients with hypertension and elevated systolic blood pressure (SBP) who presented to EDs. They were randomized to receive the VERB intervention or usual care plus education. VERB comprised educational materials, a brief motivational interview, pillbox, primary care engagement letter, pharmacy resources, and 45 days of informational and reminder text messages. On the other hand, the education arm provided a hypertension pamphlet only.

The median age of the population was 51 years, 57.3 percent of the patients were women, and 46.1 percent were Black. Self‐reported education level was high, with about 14 years of schooling. Most of the patients were prescribed more than one antihypertensive medication (56.8 percent) and reported having a BP monitor at home (58.3 percent). 

The primary clinical outcome was 30-day SBP. The median 30-day SBP was 122 mm Hg in the VERB arm and 126 mm Hg in the education arm, and the estimated mean 30‐day SBP was lower by 3.98 mm Hg (95 percent confidence interval [CI], −2.44 to 10.4) in the VERB arm (p=0.22).

Among participants enrolled after text messages were adapted, the median SBPs were 121 mm Hg in the VERB arm and 130 mm Hg in the education arm, and the estimated mean 30‐day SBP was lower by 8.57 mm Hg (95 percent CI, 0.98‒16.2) in the former (p=0.027). In this subgroup, the median response rate to VERB text messages was 56 percent (interquartile range, 26‒80).

The present data warrants further evaluation of the VERB intervention as a scalable means of controlling hypertension and engaging patients in the ED while they safely make the transition back to primary care for long‐term management.