Black Cardiovascular Disease Patients Prefer Text-Based BP Monitoring

February 22, 2022 - Black patients with cardiovascular disease (CVD) prefer recording blood pressure (BP) via a text-based program rather than an online patient portal, according to a study published in JAMA Network Open.

The study included 20 Black patients with either Medicaid or Medicare insurance. Between November 2020 and February 2021, half of these patients recorded their BP through a text-based BP monitoring program, and the other half used the online patient portal.

Before the beginning of the study, all patients received an automatic upper-arm BP cuff along with an explanation of how to use it. The patients were asked to check and record their BP twice a day for two weeks.

All patients in the text-based BP monitoring group received two texts daily that served as reminders for logging their information, which was then sent back to their provider. The online portal group received instructions on how to join the portal system and upload their statistics manually.

Each group consisted of 10 Black patients with either hypertension or cardiovascular disease.

Other requirements for participation included the ability to speak English, lack of prior BP cuff ownership, and access to a phone with text messaging.

Researchers focused primarily on how demographics related to results and the number of BP measurements between the two groups when analyzing data.

Researchers found that the text-based group provided measurements more frequently than the online portal group. All the text-based group members sent one or more BP measurements, which significantly outweighed the 30 percent of online patient portal members who did the same. The text-based group provided a mean of 20.9 BP measurements, and the online patient portal group provided a mean of 3.9 BP measurements during the study period.

The results show that Black patients with CVD who use Medicaid or Medicare insurance prefer and are far more likely to engage in a text-based BP monitoring program instead of using an online patient portal, according to the researchers.

This is likely due to the growing digital divide impacting healthcare access. The online patient portal has higher technical requirements than the text-based program, which is likely why it was not as well-used.

"Although enrollment in this study required broadband access, accessing online patient portals may be prohibitive for patients from historically marginalized groups," the study stated.

Research on telehealth access highlights this issue as well. A recent study noted that Black and low-income patients were far less likely to use video for telemedicine during the pandemic, likely due to the digital divide.

Further, text-based programs have seen success in other types of care.

A previous study published in 2018 showed that a text-based program was effective for BP management among postpartum women.