The TOUCHED Trial Demonstrates a Successful Intervention for Improving Hypertension Management

A multicomponent intervention intended for patients in the emergency department (ED) who have elevated blood pressure (BP) is effective in improving hypertension management, according to the Targeting of Uncontrolled Hypertension in the Emergency Department (TOUCHED) study that was published in JAMA Cardiology.

Hypertension is highly prevalent and affects over 115 million adults in the US, and when left uncontrolled, the condition stands as an independent risk factor for secondary cardiovascular complications. While the American College of Emergency Physicians recommends that patients who suffer from high blood pressure be referred for primary care follow-up, as noted by the researchers, “it is not known if interventions in the ED before referral to primary care improve BP outcomes.”

More Effective? Intervention or Control?

In this randomized clinical trial, researchers assessed the efficacy of an ED-based Education and mHealth Empowerment (E2) intervention and primary care referral program. The trial included 574 participants (mean age, 51) who presented to an urban academic center for any indication and had elevated BP.

Researchers randomized the population of interest to receive either an intervention or usual care at 3 and 6 months. The control arm consisted of standard discharge instructions on hypertension and a primary care referral. The intervention comprised everything included in the control arm plus an E2 education consisting of two components: a Post-Acute Care Hypertension consultation and a patient-centric mHealth intervention that combined a Bluetooth-enabled BP monitoring Health Mate app with weekly text message notifications promoting medication adherence and BP self-monitoring.

Intervention a Success

According to the findings, patients in the E2 intervention group showed a greater average reduction in SBP when compared with the control group (mean difference, 4.9 mm Hg; 95% CI, 0.8-9.0 mm Hg; P=0.02). “These findings underscore the critical importance of implementing targeted interventions at key points during health care contact, such as the ED setting, with a multidisciplinary team. Such interventions not only address immediate health needs but may also contribute to broader public health objectives with the potential to improve hypertension management,” the researchers concluded.

They added that future research “should include multicenter evaluation of this intervention, examine long-term health outcomes, and explore the patient’s perspective.”

Source:

Prendergast H, et al. JAMA Cardiol. 2025;14:e66630.doi:10.1001/jamacardio.2025.0675