self measured blood pressure monitoring: comparative effectiveness

Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. 12-EHC002-EF. Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video For SMBP plus additional support versus usual care, the strength of evidence is high and supports a lower BP with SMBP use (SBP/DBP -3.4 to -8.9/-1.9 to -4.4 mmHg) up to 12 months. Figure 2. Cookies used to make website functionality more relevant to you. In brief, ambulatory BP monitoring is a noninvasive, fully automated technique in which BP is recorded over an extended period of time, typically 24 hours. Cite this: Self-Measured Blood Pressure Monitoring to Control Hypertension-Medscape-May06,2013. Comparative Effectiveness Review No. In a comparative effectiveness review supported by the Agency for . Many studies were of moderate to poor quality and had short followup periods. 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. An official website of the United States government. No studies of SMBP monitoring in children were identified. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The bold lines correspond to the comparisons covered in this report: SMBP versus usual care (Key Question 1, part 1); SMBP plus additional support versus support without SMBP (also Key Question 1, part 1); SMBP plus additional support versus usual care (Key Question 1, part 2); SMBP plus additional support versus SMBP (Key Question 2). 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. Accessibility We also included longitudinal cohort studies in addressing adherence predictors. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. This feature requires the newest version of Flash. Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. In studies of SMBP monitoring, how does achieving BP control relate to clinical and surrogate outcomes? Addressing Barriers Beyond the Published Literature, Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association, An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring, Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness, U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening, Division for Heart Disease and Stroke Prevention, Live to the Beat Campaign Partner Toolkit. SMBP with or without additional support may confer a small benefit in BP control compared with usual care, but the BP effect beyond 12 months and the attendant long-term clinical consequences remain unclear. government site. Purpose: Patient-provider feedback loops may involve patients reporting blood pressure readings for a given time period, concerns about medications, and progress on lifestyle changes to their providers. Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. First, a health care professional wraps an inflatable cuff around your arm. High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. No studies evaluated children. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope. More broadly, though, it is the regular use of a BP measurement device that is owned by (or lent to) the patient to be used outside the office/clinic setting. Findings may be used for research purposes, but should not be considered current. Patients may require some instruction on how to use SMBP devices.30,31. [3] (Figure 2). A BP cuff is placed around the upper arm and left in place for approximately 24 hours. It has been the subject of a 2002 Evidence Practice Center (EPC) Evidence Report.25 A fuller description of ambulatory BP monitoring can be found there. 2012 Sep 21. Sit with your back straight and supported (on a dining chair, rather than a sofa). SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. Take this form [PDF 105 KB]with you on your first blood pressure visit to record important blood pressure-related information. SMBP plus clinical support interventions should be delivered by a trained healthcare provider, such as a pharmacist or nurse, and include regular communication of patient SMBP readings to providers and a patient-provider feedback loop. Measure your blood pressure regularly to help your health care team diagnose any health problems early. In addition, ambulatory BP monitoring is often used in research studies as an outcome, since many consider it to be more accurate than clinic-based BP measurement. Uhlig K, Balk EM, Patel K, Ip S, Kitsios GD, Obadan NO, et al. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. FOIA PMC Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure BP may rise in the clinic in response to the medical environment (referred to as white coat hypertension), or may be normal in the clinic but not outside of the clinic (referred to as masked hypertension).19,20 Prevalence of white coat hypertension ranges from 10 to more than 20 percent,21,22 and the prevalence of masked hypertension (MH) reaches 40 percent in some studies.23 The prognostic significance of either is unclear.24. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. They help us to know which pages are the most and least popular and see how visitors move around the site. https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. This website also contains material copyrighted by 3rd parties. Murakami L, Rakotz M. Improving health outcomes: Blood pressure. Lipid Screening in Childhood for Detection of Multifactorial Dyslipidemia: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. There is within-individual biological variability as well as measurement error. What should I do if my blood pressure numbers are high? Self-measured BP monitoring, the measurement of BP by an individual outside of the office at home, is a validated approach for out-of-office BP measurement. Taking Control of My Blood Pressure: DAngelos Story pharmacists and nurse practitioners) to manage patients' HBP (Figure 1). Patient-provider feedback loop.Source:Centers for Disease Control and Prevention. If you log out, you will be required to enter your username and password the next time you visit. Internet Citation: To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. If you are concerned about your blood pressure numbers, talk to your health care team. There is insufficient evidence concerning predictors of SMBP adherence. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. 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. Archived: This report is greater than 3 years old. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP monitoring. This site provides a list of clinically validated blood pressure devices, based on the American Medical Associations (AMA) established criteria to independently validate clinical accuracy. This resource from the Public Health Informatics Institute provides a checklist of helpful characteristics for SMBP telemonitoring software. Readings by a person can be affected by observer training, preference, and bias. CDC twenty four seven. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. Show details Contents < Prev Next > Key Informants Susan Booth Project Leader, Personal Care & Wellness Consumer Reports Yonkers, NY Hayden Bosworth, Ph.D. This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. An official website of the Department of Health & Human Services. Content last reviewed March 2021. Bookshelf Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. Piper MA, Evans CV, Burda BU, Margolis KL, OConnor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP. Unable to load your collection due to an error, Unable to load your delegates due to an error, Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. 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. Neither is there consensus on how many serial measurements should be taken and which ones should be used or averaged to derive an accurate reading. This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. : 14-05204-EF-1. SMBP = self-measured BP; KQ = Key Question. Introduction. The https:// ensures that you are connecting to the These cookies may also be used for advertising purposes by these third parties. A recent CDC study found that 67 million adult Americans have hypertension, and of those, 36 million are uncontrolled. How can I measure my blood pressure at home? John M Eisenberg Center for Clinical Decisions and Communications Science. Read the full Million Hearts Hypertension Control Change Package. Given the inconvenience and expense of setting up and using the device, ambulatory BP monitoring is predominantly used to diagnose white coat or masked hypertension, to identify people with abnormal daily BP patters, or to help with management of hard to control or highly variable BP. 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. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. There is no consensus on the precise protocol for SMBP monitoring in the management of hypertension regarding timing, frequency and duration. 1, 2 The TASMINH (Telemonitoring And SelfManagement in the Control of Hypertension) trials demonstrated that SMBP plus support, including telemonitoring (remotely monitoring patients using communication AHRQ Publication No. Rockville, MD 20857 This patient-friendly video from NACHC outlines clear instructions for using home blood pressure monitors. Before SMBP Health IT Checklist [PDF 136 KB] No studies evaluated children. This 2020 joint policy statement from the American Heart Association (AHA) and the AMA addresses barriers to implementing SMBP monitoring. [3] (Figure 1). Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. People using assistive technology may not be able to fully access information in these files. 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. Hypertension often requires lifelong treatment. This review does not explore the validity, reproducibility, or comparability of BP measurements across devices or techniques (which was addressed by the 2002 EPC report25), or the use of SMBP as a diagnostic tool. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. This 1-hour continuing medical education (CME) course focuses on the appropriate use of SMBP monitoring in clinical practice and trains physicians, care teams, and other participants who are registered for Target: BP. Future research should standardize patient inclusion criteria, BP treatment targets for home BP, and SMBP and additional support protocols to maximize the interpretability and applicability of SMBP trials. hbbd```b``A$ug`rX|" o/XDLHp0{W$5)"30^` w SMBP means you regularly use a personal blood pressure measurement device away from a doctor's office or hospitalusually at home. Where can I get my blood pressure checked? European Associations Review Dietary Therapies for Obesity, AHA Statement Ranks 10 Popular Diets for Heart Health.

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