Comparative Effectiveness Review No. b W 35D43zi&J &lbP K 7X %%EOF Self Measured Blood Pressure Monitoring (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control. For all comparisons, evidence for clinical outcomes was insufficient; for all other outcomes (surrogate and intermediate outcomes, and health care encounters) strength of evidence was low, thus failing to support a difference. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. 7 HBPM is also known as self-measured BP. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. pharmacists and nurse practitioners) to manage patients' HBP (Figure 1). To determine predictors of adherence with SMBP monitoring. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. Untreated or ineffectively treated hypertension leads to increased cardiovascular . This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No. The Forum convenes online quarterly. This graphic from Target: BP demonstrates how to prepare for a blood pressure reading, the correct position to take your own blood pressure, and how to measure it. This article presents strategies for strengthening the United States ability to address hypertension in women focusing on pregnancy-related considerations for self-measured blood pressure monitoring. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. In studies of SMBP monitoring, how does achieving BP control relate to clinical and surrogate outcomes? The direct and indirect cost of high BP and its complications has been estimated at more than $43.5 billion in 2007 in the U.S.7 Thus, it cannot be viewed simply as an individual health issue given the large public health impact and the potential for cost savings with effective prevention or treatment. This may facilitate direct communication with a provider via phone call or email and result in shorter turn-around times in responding to a BP reading and thus ultimately to better BP control. Updated Hypertension Guidelines: Implications for Treatment? https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure/research. We standardized extraction by training on multiple articles, after which each study was extracted by one methodologist and the extraction reviewed by at least one other. In total, 49 studies met eligibility criteria. What should I do if my blood pressure numbers are high? Many things can affect a blood pressure reading, including: Its important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke. Patients in the intervention group and their providers, received feedback on self-monitored blood pressure results and optional lifestyle advice and motivational support. (Prepared by the Tufts Evidence-based Practice Center under Contract No. Systematic Review: HHS Vulnerability Disclosure, Help Many have undergone validation according to the recommendations of the American Association of Medical Instrumentation, the European Society of Hypertension or the British Hypertension Society.25,29 Generally, the use of validated devices is preferred. The https:// ensures that you are connecting to the People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure. Rockville, MD 20857 52 prospective comparative studies of SMBP monitoring with or without additional support versus usual care or an alternative SMBP monitoring intervention in persons with hypertension. The Evidence-based Practice Center (EPC) reviewed the existing body of evidence on the effects of SMBP on clinical, surrogate, and intermediate outcomes in the management of hypertension. Self-Measured Blood Pressure Monitoring Definition and Indications SMBP plus additional clinical support is one alternative to traditional oce care that could improve access to care and quality of care for individuals with hypertension while making blood pressure control more convenient and accessible across the population. This report from the Public Health Informatic Institute provides key findings from a national health information technology assessment on SMBP and identifies gaps, barriers, and recommendations to advance the collection, transfer, and use of patient-generated SMBP data to improve hypertension management. John M Eisenberg Center for Clinical Decisions and Communications Science. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Self-Measured Blood Pressure: Future Research Needs: Identification of By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. Why do I need to measure my blood pressure? No studies of SMBP monitoring in children were identified. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. See the resources below for specific recommendations. Progestogens for Prevention of Preterm Birth. 45. If you have high blood pressure, talk to your health care team about steps to take to control your blood pressureto lower your risk for heart disease and stroke. SMBP monitoring can provide more frequent BP readings and if these are transmitted back to the provider, they can be used for more rapid and frequent adjustments in blood pressure medication to ensure adequate BP control. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Take your blood pressure at the same time every day. Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . This site needs JavaScript to work properly. Ann Intern Med. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. hbbd```b``A$ug`rX|" o/XDLHp0{W$5)"30^` w official website and that any information you provide is encrypted Clinic measurements may not reflect the usual BP outside of the clinic setting throughout a day. Hypertension also imposes a heavy financial burden on society at large. SMBP monitoring may not be suitable in certain patients, such as those with arrhythmias and ectopic beats, large arm circumferences (as a too-small cuff size may give falsely elevated BP readings), with physical or mental disabilities that interfere with device operation. A connected monitor is preprogrammed to regularly record BP, usually every 15 to 20 minutes while awake and every 20 to 30 minutes while asleep. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. To review the role of self-measured blood pressure (SMBP) monitoring with or without additional support (interventions such as telemonitoring, counseling, education, Web support, behavioral interventions, home visits, etc.) Federal government websites often end in .gov or .mil. The Correct Way to Measure Blood Pressure Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] How to Measure Your Blood Pressure at Home [PDF 255 KB] Federal government websites often end in .gov or .mil. . Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Providers can help with SMBP implementation by promoting SMBP to their hypertensive patients and establishing clinical feedback systems. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Patients may require some instruction on how to use SMBP devices.30,31. A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. This toolkit, developed by the National Association of Community Health Centers (NACHC) for Million Hearts, can help organizations successfully integrate SMBP monitoring into care processes and workflows. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence They help us to know which pages are the most and least popular and see how visitors move around the site. There are also a variety of kiosks available in stores and pharmacies. These types of minimally intensive approaches are important to test in all populations, especially those experiencing related health disparities, for broad implementation with . Measurements may interfere with a patient's activity or sleep. Your feet should be flat on the floor and your legs . Ann Intern Med. Research shows that SMBP: Can improve adherence and health outcomes for hypertensive patients1 What you need to know about self-measured blood pressure monitoring A reading that says your blood pressure is higher than it actually is may lead to treatment you dont need. This 2020 joint policy statement from the American Heart Association (AHA) and the AMA addresses barriers to implementing SMBP monitoring. The cost of a home BP monitor ranges between $40 to $150, and the insurance coverage and approval for these devices vary across states.33 However, provision of the device could be cost-saving if it resulted in a reduced number of office visits for BP measurement or management or resulted in improved BP, which could translate into reduced morbidity and health care utilization. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Resource description: This research summary of a systematic review compares the effectiveness of various methods and approaches to blood pressure measurement by patients or companions. The full report, listing all studies, is available at www.effectivehealthcare.ahrq.gov/selfmeasuredbp.cfm. This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. To summarize evidence about the effectiveness of self-measured blood pressure (SMBP) monitoring in adults with hypertension. The .gov means its official. An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring How do different devices for SMBP monitoring compare with each other (specifically semiautomatic or automatic versus manual) in their effects on clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence)? Self-Measured Blood Pressure Monitoring: Comparative Effectiveness This list of resources from the Million Hearts Hypertension Control Change Package can help assign care team roles for an SMBP monitoring program and guide patients on selecting a home blood pressure monitor. Self-blood pressure monitoring, by itself, has been shown to be an effective tool in predominantly white populations, but less studied in minority, urban communities. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. Self-measured blood pressure (SMBP) has been used in the treatment of hypertension with three major aims: 1) to avoid undertreatment of hypertension 2) to enhance self-participation in disease management and to enhance adherence; and 3) to avoid overtreatment in those with lower BP out of the clinic compared with in the clinic26, SMBP is being used to avoid undertreatment of hypertension. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. Apr 11, 2011. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers. This video from NACHC, showcases several community health centers work to implement SMBP monitoring programs in their clinics. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Learn the correct way to have your blood pressure taken, whether youre getting it checked at the doctors office or checking it yourself at home. Several national and international hypertension guidelines endorse self-measured BP monitoring. This report focuses on SMBP monitoring as a strategy to help patients and clinicians to better manage and control hypertension while avoiding under- or overtreatment or treatment-related hypotension. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension. An official website of the Department of Health & Human Services, Internet Citation: Self-measured blood pressure (SMBP) monitoring, sometimes called home blood pressure monitoring, is a patient- performed measurement of their own blood pressure outside of a clinical setting. Agency for Healthcare Research and Quality (US), Rockville (MD). In total, 49 studies met eligibility criteria. Taking Control of My Blood Pressure: DAngelos Story Content last reviewed March 2021. 2011 Aug 8. This AMAAHA joint initiative can help health care professionals launch an SMBP monitoring program. The .gov means its official. Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure. sX Ndb`T~ 0 The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels. This website requires cookies, and the limited processing of your personal data in order to function. : 13-05194-EF-1. include self-measured blood pressure monitoring (SMBP) plus additional clinical support and empowerment of non-physician clinicians (e.g. For appropriate diagnosis and therapy, accurate BP measurement is of great importance. You will be subject to the destination website's privacy policy when you follow the link. Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. This easy-to-read graphic from CDC shows patients the correct way to measure blood pressure and can be shared on your social channels and patient websites. Centers for Disease Control and Prevention. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. This includes encouraging the purchase of fully automated, validated home blood pressure monitors with a properly sized arm cuff, training patients in SMBP techniques, checking patients' measurement techniques for accuracy, and interpreting and providing counseling based on shared blood pressure readings. pressure monitoring and refers to the regular use of a SMBP plus clinical support can improve access to care and quality of care for people with hypertension while making blood pressure control more convenient and accessible across the population. Disclaimer. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Very few trials evaluated objective clinical outcomes. PDF Science-in-Brief Feature: Self-Measured Blood Pressure Monitoring - CDC i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i This 2021 recommendation from the USPSTF includes additional guidance for obtaining blood pressure measurements away from the clinical setting. The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. Self-measured blood pressure (SMBP) monitoring, the regular measurement of blood pressure (BP) by the patient at home, has been proposed as a means of improving treatment adherence and BP control. There were 24 comparisons of SMBP alone versus usual care, 24 of SMBP plus additional support versus usual care, 12 of SMBP plus additional support versus SMBP without additional support or with less intense additional support, and 1 study evaluating predictors of adherence to SMBP. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening The actual BP measurement can be done either by the patient, or less frequently by a companion, who is usually not a medical professional. Please enter a Recipient Address and/or check the Send me a copy checkbox. These blood pressure monitors are easy and safe to use. Million Hearts Science team, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GeorgiaDisclosure: Allison Goldstein, MPH, has disclosed no relevant financial relationships. 8. Ambulatory BP monitoring requires a technologist to program the machine, fit it on the patient, remove it and download the results and a physician to interpret them. Background Hypertension often requires lifelong treatment.
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