Feasibility of a mobile blood pressure telemanagement system in children with hypertension

Telemedicine interventions are being increasingly used in the care of adults with hypertension however application of these technologies in children with high BP has not been systematically studied. The goal of this project was to develop a mobile BP telemanagement system for children with hypertension and to evaluate its feasibility. The prototype system consisted of a home unit, decision support server, and care management site. The home unit was based on a wireless netbook and automated BP monitor. The home unit was designed to complete a symptom diary, assess medication side effects, obtain BP, undergo hypertension education, and communicate with the decision support server. Feasibility of the BP telemanagement system was assessed in 8 children ≤21 years of age with essential hypertension. The study participants were asked to review the system functionality and provide their feedback by completing attitudinal survey and semi-structured qualitative interview. Attitudinal survey results were as follows: 88% reported that working with the computer was not difficult; 100% reported that self-testing procedures were not complicated; 75% felt the self-testing procedure took little time and did not interfere with their usual activities; 63% felt safer while being monitored by the BP telemanagement system; 63% felt it was important to know that the self-testing results can be immediately reviewed in the medical center; 88% would like to use the home telemonitoring system in the future. Qualitative interview results showed consistently positive comments for content, interface and process components and provided suggestions for improvements. We concluded that BP telemanagement in children may be feasible means for hypertension care delivery, and that further development and evaluation of the system is warranted.