Engaging Home-monitored Assessment to Navigate Clinical Decision-making (ENHANCe)

Engaging Home-monitored Assessment to Navigate Clinical Decision-making -The ENHANCe Study

This study is testing a new app called ENHANCe, which is designed to help family doctors manage patients with high blood pressure using readings taken at home.

Study Overview

• Status: Enrolling by invitation
• Conditions: Hypertension,Essential
• Intervention / Treatment: Device: ENHANCe app; Other: Teaching and training; Other: Usual care

Detailed Description

The researchers want to find out if the app is easy to use in everyday clinic settings, whether doctors find it helpful and are willing to use it, and if it helps improve care. The study will involve 16 doctors and 100 patients with high blood pressure, split into two groups at two clinics. One group will use the ENHANCe app, which can read blood pressure data from different sources-including handwritten notes-and give doctors advice based on that information. The other group will receive regular care without the app. Over six months, researchers will collect feedback from doctors through surveys and group discussions at the end of the study. They'll also track how many people complete the study, how long clinic visits take, whether doctors follow the app's advice, and how well patients' blood pressure is controlled. The goal is to see if the app can help doctors make faster, better decisions and improve health outcomes for people managing their blood pressure at home.

• Study Type: Interventional
• Enrollment (Estimated): 116
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Singapore
  • Singapore
    • Singapore, Singapore, Singapore, 150167
      • SingHealth Polyclinics

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

For primary care physicians:

• PCPs aged 21 years and above.
• Involved in the clinical management of patients with hypertension in the past six months.

For patients:

• Patients aged 21 years and above
• Documentation of hypertension diagnosis in EMR
• Owns an HBP monitoring device

Exclusion Criteria for patients:

• Documentation of dementia diagnosis in EMR
• Audio or visual impairments
• Hypertensive urgency or emergency

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Hypertension management using the Clinical Decision Support System; All patients will have access to online educational resources throughout the study. After recruitment, they will receive a nurse-led education on HBP monitoring. The research team will train all primary care physicians (PCPs) on managing patients with hypertension using HBP records. The PCPs in the intervention group will be briefed on how the ENHANCe app works, and its recommendations. The ENHANCe app will be installed on designated mobile phones, and research staff will analyse HBP records during visits, documenting the output for PCPs to use. Based on the app's recommendations, patients will consult with intervention group PCPs 2-3 times throughout the study, with the last follow-up at 6 months. PCPs will complete a consult checklist after each visit. FGDs will be conducted with PCPs at the end of the study. The interviews will be recorded and transcribed for analysis.	Device: ENHANCe app; ENHANCe app is a prototype; it is a smartphone based clinical decision support (CDS) tool to manage patients with hypertension using their home blood pressure. The app will scan patients' home BP records from paper or mobile phone, and provide a recommendation to the doctor on how to manage their blood pressure. The patient will not need to use the device during the study period. However, the recommendation from the ENHANCe app will be available to the doctor to manage your blood pressure during the study period if the patient is in the intervention group.; Other: Teaching and training; All patients will have access to online educational resources throughout the study. After recruitment, they will receive a nurse-led education on HBP monitoring. The research team will train all primary care physicians (PCPs) on managing patients with hypertension using HBP records.
Other: Hypertension management as per usual care without a clinical decision support system; All patients will have access to online educational resources throughout the study. After recruitment, they will receive a nurse-led education on HBP monitoring. The research team will train all primary care physicians (PCPs) on managing patients with hypertension using HBP records. Control group PCPs will manage patients using HBP records at their discretion, with a final follow-up scheduled at 6 months. PCPs will complete a consult checklist after each visit. Research staff will use the ENHANCe app to analyse BP diaries and document outcomes, but control group PCPs will not have access to the app or its results.	Other: Teaching and training; All patients will have access to online educational resources throughout the study. After recruitment, they will receive a nurse-led education on HBP monitoring. The research team will train all primary care physicians (PCPs) on managing patients with hypertension using HBP records.; Other: Usual care; Physicians manage patients using HBP records at their discretion

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Response rate of participants	Participants agreeable to participate in the study	6 months
Agreement with the CDSS recommendation among PCPs	Proportion of PCPs who agree with the CDSS recommendation in the two groups	6 months
Withdrawal rate	Proportion of participants who withdrew	6 months
Study completion rate	Proportion of participants who completed the intervention	6 months
Adverse event rates	Proportion of adverse events reported in the two groups	6 months
Consult duration	Consult time in the groups	6 months
Ease of home blood pressure record assessment among PCPS	Ease of home blood pressure record assessment among PCPS in the two arms	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of CDSS recommendation followed by the PCPS	Proportion of ENHANCe recommendations followed by the PCPs among the two groups	6 months
Blood pressure control status	Blood pressure control status among patients in the two groups	6 months

Collaborators and Investigators

• Sponsor: SingHealth Polyclinics
• Collaborators: Nanyang Polytechnic

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2025
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: December 28, 2025
• First Submitted That Met QC Criteria: February 2, 2026
• First Posted (Actual): February 10, 2026

Study Record Updates

• Last Update Posted (Actual): February 10, 2026
• Last Update Submitted That Met QC Criteria: February 2, 2026
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Hypertension; Primary Care; Home blood pressure; Clinical decision support system
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Essential Hypertension; Hypertension; Socioeconomic Factors; Population Characteristics; Educational Status
• Other Study ID Numbers: 2024-4269-APP1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: IPD will not be shared

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No