The Review Cycle in Hypertension Plus

NICE Hypertension Guidelines recommend that blood pressure should be taken in the morning and evening for at least 4 days, ideally for 7 days to achieve an accurate average blood pressure reading. The Hypertension Plus Programme uses the concept of the "Measurement Week" to prompt patients to measure and record their blood pressure during the morning and the evening 1 week each month or 1 week every 6 months. The average reading from these measurement weeks is used to determine whether a patient has their blood pressure under control.

If a patient records an average blood pressure above their target, Viso will trigger an action to the HCP with a recommendation to move to the next step in the patient’s treatment plan. If a patient records an average blood pressure below their target, the patient will be encouraged to continue taking their medication according to the current step in their plan.

If a patient misses a measurement, they should continue to measure as normal in the subsequent days. Viso will automatically extend the measurement week by up to 7 additional days to ensure that enough data is collected.

If a patient does not submit any measurements, their Measurement Week is marked as “missed”. The patient will continue their current medication step until the next Measurement Week (28 days after the start of their previous week). If a patient does not complete enough measurements within 14 days, their Measurement Week is marked as “incomplete”. An action card will be triggered for you to review the data that your patient has submitted and decide if any action should be taken. With an Incomplete Measurement Week action card you can still move a patient to the next step of their treatment plan if desired.

NICE Guidelines for hypertension recommend that blood pressure should be taken in the morning and evening for at least 4 days, ideally for 7 days. The default Measurement Week in Viso consists of 14 measurements. However, if the patient’s blood pressure is >5 mmHg above or below than their target after 8 sets of readings, Viso may stop the Measurement Week early, because there is sufficient confidence that the actual blood pressure is well known.

A patient is started on a 1-month Measurement Week cycle by default. This means that their Measurement Week will start on a Saturday, 28 days after the start of the previous Measurement Week. The following cases may change this duration:

• If the patient has 2 consecutive Measurement Weeks with controlled blood pressure –this is either marked by their doctor for incomplete Measurement Weeks or achieved when a patient's blood pressure is within target for completed Measurement Weeks – they will be moved to a 6-month measurement cycle. Their next Measurement Week will start on a Saturday 6 months after the previous Measurement Week.
• If the patient misses a Measurement Week, or records a Measurement Week above target, they will be moved back to a 1-month Measurement Week cycle.
• When a patient begins a new medication step, they can be requested to confirm the receipt of their medication (this option is a non-default setting) and update their medication schedule. The next Measurement Week will always start on the next Saturday following a 21-day period where the patient should be taking the new medication.

If just the single daily required measurement, patient can take measurement for the next day. Based on HCP users' instruction, patient can takes required measurement within the new programme review cycle.

The history raw data can be viewed in detailed monitoring overview screen by clicking view all measurements button on each graphs.

Drug intolerance need to be added when enrolling a patient. If Viso is connected to the EMR of your clinic, this information will be available while completing the patient enrolment but can also be added manually with "Patient Settings".

Yes, you can add multiple monitoring programme for a single patient.

You can remove a programme for monitoring from your patient. Historical information will not be lost. Your patient will no longer be prompted to do activities or tasks within the app.

Data history will remain in the system and data that has been shared within EMR will be still available as this might be scope of the decision making of treatment.

Yes, you can change assigned HCP approver for a certain patient in patient setting screen, or you can require ICS or PCN admin to change the responsible HCP approver when they remove the user.

By editing related programme, you can change target by clicking manage programme button in patient detailed screen. And you will move to the corresponding programme and allow to update target values in the related screen.

By editing related programme, you can change target by clicking manage programme button in patient detailed screen. And you will move to the corresponding programme and can update alert values in the related screen.

You can find the test results in patient monitoring details screen.

Yes, you can manage specialist review of patient to other HCP within the Dashboard. It is not possible to send specialist request to HCP Clinical expert outside of the actual user group of Viso.

When looking at the Patients Details screen, you can check "Manage programmes". Choose the programme you want to personalise for your patient and change the settings/frequency/threshold.