self measured blood pressure monitoring: comparative effectiveness
Rockville, MD 20857 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. Background: In people with hypertension (adults and children), does self-measured blood pressure (SMBP) monitoring, compared with usual care or other interventions without SMBP, have an effect on clinically important outcomes? Target: BP: Implement SMBP You can review and change the way we collect information below. That the mean number of BP measurements recorded per week for users who continued recording blood pressure at 6 weeks was 6 compared to 8 among those who continued for at least 14 weeks, demonstrates high levels of engagement with respect to self-measured BP monitoring. 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. Other factors that can improve accuracy include the use of an appropriately sized cuff and slow cuff deflation. Read the full Million Hearts Hypertension Control Change Package. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. You will be subject to the destination website's privacy policy when you follow the link. Numerous health professional and government organizations have developed various guidelines for BP management. 7 HBPM is also known as self-measured BP. : 12-EHC002-EF. To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. 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. CDC twenty four seven. 2012 Feb 15. Purpose Hypertension often requires lifelong treatment. 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. 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. Progestogens for Prevention of Preterm Birth. Self-Measured Blood Pressure Monitoring . Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. How can I measure my blood pressure at home? What is the correct way to measure blood pressure? Content last reviewed March 2021. Topline Findings: A National Analysis of Self-Measured Blood Pressure Monitoring Coverage and Reimbursement [PDF 1.7 MB] Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. Patient-provider feedback loop with clinical support for SMBP monitoring. 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. Unauthorized use of these marks is strictly prohibited. pharmacists and nurse practitioners) to manage patients' HBP (Figure 1). These evidence-based action steps and resources, assembled by Million Hearts, can help practices implement SMBP monitoring. This feature requires the newest version of Flash. Internet Citation: For the purpose of this report, BP measurement by the patient in the office/clinic/pharmacy or a health unit at work is not included under SMBP monitoring since it does not reliably overcome the problem of white coat hypertension nor provide the privacy and opportunity for more frequent measurements of home self measurement. 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. 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. Centers for Disease Control and Prevention. . Bethesda, MD 20894, Web Policies Bethesda, MD 20894, Web Policies 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 [Internet]. Strong scientific evidence shows that self-measured blood pressure (SMBP) monitoring, also known as home blood pressure monitoring, plus clinical support helps people with hypertension lower their blood pressure. How do health care professionals measure my blood pressure? official website and that any information you provide is encrypted Untreated or ineffectively treated hypertension leads to increased cardiovascular morbidity and mortality in individuals, increased consumption of health care resources, high financial and human costs to society. AHRQ Publication No. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. Untreated or ineffectively treated hypertension leads to increased cardiovascular . The primary objective of this review is to evaluate whether the use of SMBP monitoring influences outcomes in adults and children with hypertension and to what extent these changes in outcomes can be attributable to the use of self monitoring devices alone or the use of SMBP with additional support or attention provided. Support interventions can be delivered outside of a normal office visit -- for example via telephone, email, or Internet portal -- thereby reducing the necessary frequency of face-to-face visits. 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. The CDC 6|18 Initiative supports providing access for SMBP monitoring for home use and creating individual, provider, and health system incentives for compliance and meeting goals. Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. No studies evaluated children. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. All information these cookies collect is aggregated and therefore anonymous. Cookies used to make website functionality more relevant to you. There is growing evidence that selfmonitoring of blood pressure (SMBP) with guided support beyond usual primary care improves BP control. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP monitoring. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. Centers for Disease Control and Prevention. Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Strategies aimed at the control of high BP as well as adherence to medication continue to be of foremost concern to providers and patients, health care payers, policymakers, and governments worldwide. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. The health care professional then inflates the cuff, which gently tightens on your arm. This website requires cookies, and the limited processing of your personal data in order to function. This table from a 2021 Current Atherosclerosis Reports journal article features oscillometric blood pressure devices validated for accuracy during pregnancy. Please confirm that you would like to log out of Medscape. 2012 Mar 19. 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. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. An official website of the United States government. To sign up for updates or to access your subscriberpreferences, please enter your email address below. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. 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. 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. Tools to Establish a Self-Measured BP (SMBP) Monitoring Program [PDF 2 MB] Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] Patient-provider feedback loop.Source:Centers for Disease Control and Prevention. Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [PDF 1.2 MB] This 2020 AMA handout for Current Procedural Terminology (CPT) provides codes and descriptions for SMBP-related services. Ann Intern Med. Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they dont use SMBP.3. 2011 Aug 8. 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. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. 8600 Rockville Pike An official website of the United States government. Cookies used to make website functionality more relevant to you. For SMBP alone versus usual care, the strength of evidence is moderate and supports a lower BP with SMBP (SBP/DBP -3.1/-2.0 mmHg at 6 months). A health care team member can show you how to use one if you need help. PMC Lozano P, Henrikson NB, Morrison CC, Dunn J, Nguyen M, Blasi P, Whitlock EP. The bold lines indicate the comparisons addressed in the Key Questions (see below). 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]. Accessibility Updated Hypertension Guidelines: Implications for Treatment? 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. A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was . Agency for Healthcare Research and Quality, Rockville, MD. Unauthorized use of these marks is strictly prohibited. They help us to know which pages are the most and least popular and see how visitors move around the site. and transmitted securely. Topic Initiated. The https:// ensures that you are connecting to the hXio8EIbHr)_cBCq{(1KLL)}]IDb)Pb"VL *&DSK28ijMqXLG:a/^~ vs:?COe+Y1~504ye49ucTSQZGUI+'O+ {EQZu]`^.7t n\B^9~: MeSH 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. All information these cookies collect is aggregated and therefore anonymous. Division for Heart Disease and Stroke Prevention. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure government site. Whether or not to advise the use of an SMBP monitoring device for a patient with hypertension is a common clinical question for clinicians. Data Sources: Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video In total, 49 studies met eligibility criteria. 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. Hypertension Medication for Specific Comorbidities, Individualized Weight Monitoring Using the Heartphone, Home Blood Pressure Monitoring in Patients With Hypertension. 12-EHC002-EF. 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. Murakami L, Rakotz M. Improving health outcomes: Blood pressure. HHSA 290-2007-10055-I.) Data Synthesis: No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. SMBP differs from clinic-based and ambulatory blood . The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. 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. Page originally created December 2020. 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. 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. Brown Affiliations and transmitted securely. The https:// ensures that you are connecting to the We take your privacy seriously. 45. [3] (Figure 2). This video from NACHC features DAngelo, a patient who explains how he has taken control of his blood pressure with the help of SMBP monitoring. The choice of treatment is largely dependent on the cause of hypertension, severity of the condition, as well as the presence or absence of existing comorbid states. This video from the NACHC features Natalia, a patient who explains how she has taken control of her blood pressure with SMBP monitoring. 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. An official website of the Department of Health and Human Services, Latest available findings on quality of and access to health care. In otherwise healthy adults, hypertension is defined as a persistently elevated BP equal to or greater than 140/90 mmHg.1 The recommended BP measurement technique is to average two readings taken in a person after 5 minutes quietly seated in chair.1 In children, the diagnosis is made from an average of three or more BP readings greater than the 95th percentile for age, sex, and height.2,3 The Seventh Joint National Committee (JNC 7) guideline recommends a BP goal of 140/90 mmHg or less in the general population and a lower goal of 130/80 mmHg or less in patients with diabetes mellitus or chronic kidney disease.1.