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Feasibility and acceptability of a remote blood pressure monitoring pharmacist-led telehealth programme in an emergency department transition care clinic: a pilot randomised controlled trial

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Objectives To evaluate the feasibility, fidelity and acceptability of a pharmacist-led remote blood pressure monitoring (RBPM) telehealth intervention in an emergency department postdischarge clinic (ED-PDC) and to assess preliminary effects on systolic blood pressure (SBP) over 12 weeks. Design Pilot randomised controlled trial (RCT) with a parallel-group (1:1) design. Setting Academically affiliated ED-PDC in Alabama, USA (July 2024–January 2025). Participants Adults aged ≥18 years with SBP 130–160 mm Hg, English-speaking, smartphone owners and without an established primary care provider. The cohort was predominantly Black (71%), 38% female, with a mean age of 48.4±12.8 years. 24 were randomised (12 per arm). Interventions Participants were randomised to RBPM (Withings BPM Connect Pro) with weekly pharmacist-led telehealth visits or to usual ED-PDC care. Both arms received hypertension education and completed a 12-week in-person follow-up. Primary and secondary outcome measures Primary outcomes were recruitment, 12-week retention and intervention fidelity. Secondary outcomes included acceptability (acceptability of intervention measure (AIM), intervention appropriateness measure (IAM) and feasibility of intervention measure (FIM)). The exploratory clinical outcome was the change in SBP at 12 weeks. Results Of the 27 people screened, 24 were randomised, and 16 (67%) completed the 12-week in-person visit (n=8 in each arm). RBPM participants completed a mean of 10.6±3.3 of 12 planned pharmacist visits. Acceptability was high (AIM 4.69±0.88; IAM 4.75±0.71; FIM 4.78±0.41). Mean SBP decreased from 153.5±15.8 to 128.9±21.0 mm Hg in the RBPM arm (p=0.024) and from 158.1±21.9 to 133.0±21.6 mm Hg in the usual care arm (p=0.003); the between-group difference was 0.5 mm Hg (95% CI −25.7 to 26.7). At 12 weeks, 75% (6/8) of RBPM participants achieved SBP ≤130 mm Hg versus 50% (4/8) in usual care. Conclusions A pharmacist-led RBPM telehealth programme integrated into an ED-PDC is feasible, highly acceptable and associated with meaningful SBP reductions and a higher rate of BP control in the RBPM arm. These promising findings support a fully powered multisite RCT. Trial registration number ClinicalTrials.gov NCT06247111.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-121681