Outpatient blood pressure monitoring using bi-directional text messaging

- Patients may fail to comply with requests for home blood pressure measurements
- Sending text reminders increased the number of blood pressure readings recorded
- Bi-directional text messaging outperformed simple text reminders

To diagnose hypertension, multiple blood pressure (BP) measurements are recommended. We randomized patients into three groups: EMR-only (patients recorded BP measurements in an electronic medical record [EMR] web portal), EMR + reminders (patients were sent text message reminders to record their BP measurements in the EMR), and bi-directional text messaging (patients were sent a text message asking them to respond with their current BP). Subjects were asked to complete 14 measurements. Automated messages were sent to each patient in the bi-directional text messaging and EMR + reminder groups twice daily. Among 121 patients, those in the bi-directional text messaging group reported the full 14 measurements more often than both the EMR-only group (P < .001) and the EMR + reminders group (P = .038). Also, the EMR + reminders group outperformed the EMR-only group (P < .001). Bi-directional automated text messaging is an effective way to gather patient BP data. Text-message-based reminders alone are an effective way to encourage patients to record BP measurements.