Research Article
First Use of an Ingestible Sensor to Manage Uncontrolled Blood Pressure in Primary Practice: The UK Hypertension Registry
Naik R1, Macey N2, West RJ3, Godbehere P4, Thurston SC5, Fox R6, Xiang W7, Kim Y8, Singh I9, Leadley S10 and DiCarlo L11*1Department of Medicine, Far Lane Medical Centre, United Kingdom
2Department of Medicine, StoHealth, Violet Hill House, United Kingdom
3Department of Medicine, Woolpit Health Centre, United Kingdom
4Department of Medicine, North Brink Practice, United Kingdom
5Department of Medicine, Wymondham Medical Practice, United Kingdom
6Department of Medicine, The Health Centre, United Kingdom
7Data Management, Proteus Digital Health, London, United Kingdom
8Data Analytics, Proteus Digital Health, London, United Kingdom
9Clinical Operations, Proteus Digital Health, London, United Kingdom
10Clinical Support, Proteus Digital Health, London, United Kingdom
11Medical Affairs, Proteus Digital Health Ltd., London, United Kingdom
- *Corresponding Author:
- Lorenzo DiCarlo, MD
Head, Global Clinical Affairs, Proteus Digital Health, Inc.
2600 Bridge Parkway, Redwood City, California, 94109, USA
Tel: +1 415 806 9000
E-mail: ldicarlo@proteus.com
Received date: February 21, 2017; Accepted date: February 27, 2017; Published date: February 28, 2017
Citation: Naik R, Macey N, West RJ, Godbehere P, Thurston SC, et al. (2017) First Use of an Ingestible Sensor to Manage Uncontrolled Blood Pressure in Primary Practice: The UK Hypertension Registry. J Community Med Health Educ 7:506. doi:10.4172/2161-0711.1000506
Copyright: © 2017 Naik R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Primary care physicians used a CE-marked ingestible sensor in a real world setting to assess patients with persistent hypertension. The objectives were to (1) characterize the pattern of their medication use, (2) differentiate medication use from pharmacologic unresponsiveness as a potential underlying cause for uncontrolled hypertension; (3) categorize and summarize subsequent management decisions; and (4) assess the usability and acceptability of passive electronic monitoring for managing hypertension.
Methods: There were 167 patients with uncontrolled hypertension whilst chronically prescribed 2 to 5 antihypertensives; 40% were chronically prescribed ≥ 3 antihypertensives. Patients were instructed to ingest a pharmacologically inert tablet containing the ingestible sensor whenever they took their prescribed medications. A wearable sensor on the patient's torso passively recorded the dates/times of tablet ingestion. Taking adherence (i.e., the total number passively detected divided by the total number prescribed) and timing adherence were determined for a period of two weeks with no change in therapy.
Findings: Taking adherence ranged from 53-100%; timing adherence ranged from 21-100%. Systolic blood pressure decreased from 154 ± 13 to 145 ± 18 mmHg (mean -9.7 mmHg; 95% CI: -12.5, -7.0 mmHg, p<0.001). Diastolic blood pressure decreased from 85 ± 11 to 80 ± 12 mmHg (mean -5.0 mmHg; 95% CI: -6.5, -3.5 mmHg, p<0.001). Thirty-two percent (32%) of participants achieved their treatment goals using their existing therapy. Subsequent management included: medication reviews and/or adherence counseling with no anti-hypertensive changes in 81%, anti-hypertensive changes in 13%, referrals to specialists in 1%, and no additional actions were taken in 6%. Practitioners found the offering easy to utilise, and the majority of patients expressed a positive experience in using it.
Conclusion: In patients with uncontrolled blood pressure, the inclusion of an ingestible sensor in everyday practice helped practitioners to identify potential factors contributing to persistent hypertension and to determine subsequent patient-specific interventions.