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Digital pills cut blood pressure faster

Patients with uncontrolled hypertension and type 2 diabetes using digital medicines had larger 4-week SBP drops than usual care.

Source

Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial

Frias J, Virdi N, Raja P, et al. · Journal of medical Internet research · 2017

doi.org/10.2196/jmir.7833Read the full paper ↗154 citationscc by

What they did

A 12-week open-label cluster-randomized three-arm pilot at 13 US primary-care sites compared 4-week DMO, 12-week DMO, and usual care for uncontrolled HTN with T2DM.

What they found

DMO users had about 9 mm Hg greater SBP reduction by week 4, more patients at BP goal by week 12, and larger LDL-C declines; HbA1c also trended lower.

The limits

What it doesn't show

Long-term hard cardiovascular events, blinded placebo effects, or performance outside motivated primary-care clusters.

Key terms

DMO
Digital medicine offering—sensor-enabled medicines with adherence feedback.
SBP
Systolic blood pressure, the primary endpoint at week 4.
Cluster randomization
Sites—not individual patients—assigned to study arms.
Modified ITT
Analysis set after excluding a compromised usual-care site.
LDL-C
Low-density lipoprotein cholesterol, an exploratory lipid outcome.
Uncontrolled HTN
Blood pressure above target despite available treatments.

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Primary endpoint was:

Common questions

What was the primary endpoint?

Change in SBP from baseline to week 4.

How large was the analytic sample?

109 participants in the modified-ITT set.

How much greater was SBP reduction?

About 9 mm Hg greater with DMO by week 4.

What happened to LDL-C?

Greater reductions with DMO (−33.2 at week 4; −19.2 at week 12 vs usual care).

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