eSMART-HTN: An Electronic Hypertension Self-Management Intervention for Improving the Quality of the Patient-Provider Interaction

Hypertension is a life-limiting chronic condition that predisposes individuals to increased risk of morbidity, disability, and mortality. The growing number of individuals with HTN in the United States and worldwide represent a significant public health concern, and strategies to prevent, manage, and enhance blood pressure control are warranted. Across the self-management literature, the quality of interaction between patients and providers has been a central component in the initiation and maintenance of self-management. Prior hypertension self-management interventions have focused on medication adherence and self-monitoring using different approaches including technological support. At present, no single technological intervention has been demonstrated to be uniformly effective. Advancements in computer software and gaming technology present new opportunities to support patients by enhancing the quality of their interactions with providers. Therefore, the primary purpose of this presentation is to evaluate the effects of two electronic hypertension self-management interventions on the quality of the patient-provider interaction among community dwelling adults with hypertension. A nonprobability sample of 109 adults with hypertension participated in randomized controlled trial. Participants were randomly assigned to an avatar-based simulation (eSMART-HTN) or a video presentation on hypertension self-management (attention control). Data were collected at baseline, and then monthly for three months. A reliable and valid measure, the Questionnaire of the Quality of the Patient-Provider Interaction (QQPPI), was used to capture the subjects’ appraisals of their interactions with providers managing their high blood pressure. While there was no significant difference between groups, the eSMART-HTN group demonstrated significant improvements in their QQPPI scores across time. The study supports the role of an interactive computer based intervention to increase the quality of patient-provider interaction. Future research should examine key success factors and mechanisms of the eSMART-HTN intervention that led to improved patient-provider interaction. By understanding those factors and mechanisms, eSMART-HTN could serve as a tool for tailored hypertension self-management intervention.