Home Blood Pressure Telemonitoring and Hypertension Management in Kenya: A Feasibility Study (HBPT-K)

Objective: To determine the feasibility of home blood pressure telemonitoring (HBPT) in Kenya and explore its effects on blood pressure (BP) regulation, self-reported drug adherence, patient- and healthcare provider satisfaction, and required telemonitoring time investment. Methods: Six-month single-arm interventional feasibility study. Hundred adults with newly diagnosed or known hypertension with an office BP > 140/90 mmHg were provided with a BP machine and were enrolled in an HBPT program. Primary outcome was BP control (% BP < 140/90 mmHg) between baseline and T = 6 months (SPRINT standardized in-office blood pressure measurement). Secondary outcomes included self-reported adherence (MARS-5 scale), patient- and healthcare provider satisfaction (TUQ and MAUQ questionnaires), and efficiency (time spent processing the blood pressure telemonitoring data). Results: Between March 2024 and January 2025, 100 patients gave informed consent to participate in the study. Eighty-four patients (mean age 54, SD = 14, 73% females) completed the six-month follow-up and were included in the final analysis. Blood pressure control improved from 0% to 72% after six months (P < 0.0001). Median MARS-5 score at baseline was 25 (IQR 25-25) and remained 25 (IQR 25-25) at T = 6 months. Patient satisfaction scores were high with a median mHealth App Usability Questionnaire (MAUQ) score (range 1-7) of 7 (IQR 6.97-7) and a median Telehealth Usability Questionnaire (TUQ) (range 1-7) score of 6.95 (IQR 6.86-7). Patients participated for an average of 9.2 months in the telemonitoring program and required an E-nurse time investment of 51.7 minutes to process BP data. Conclusions: HBPT is feasible and improved BP control in a rural setting with limited time investments and high patient- and healthcare provider satisfaction rates. Trial Registration: This study is registered with the Pan African Clinical Trial registration (pactr.samrc.ac.za, trial ID: PACTR202408912454189).