This document provides action steps for public health practitioners to facilitate the implementation of SMBP monitoring plus additional support in five key areas: Understanding the environment; Working with payers and purchasers; Working with health care providers; Spreading the word to the public; and Monitoring/assessment of SMBP, plus additional support implementation. 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.) Ann Intern Med. Disclaimer. Would you like email updates of new search results? Taking Control of My Blood Pressure: DAngelos Story In: Daniel D, Prall M, editors. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Dec. Report No. Choosing-a-Home-BP-Monitor At-a-Glance-Comparison [PDF 446 KB] 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 summary is provided to assist in clinical decisionmaking along with consideration of a patient's values and preferences. This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. Reliable clinic measurements require an adequate rest period prior to measurement in order to enhance the consistency of BP readings. In addition, SMBP may carry the risk of unreliable BP readings if not obtained in a standard fashion, inappropriate self adjustments of antihypertensive medications, as well as increased anxiety in susceptible patients. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. This AMAAHA joint initiative can help health care professionals launch an SMBP monitoring program. hbbd```b``A$ug`rX|" o/XDLHp0{W$5)"30^` w 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. Background: Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. Measure your blood pressure regularly to help your health care team diagnose any health problems early. Rockville, MD 20857 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. Share this graphic with family and friends to show them the correct way to measure blood pressure. Data extraction Data on . 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Recommended management strategies for BP control include lifestyle and behavior modification (such as smoking cessation, moderation of alcohol consumption, salt restriction and other dietary modifications, regular exercise, and weight loss in obese persons), usually combined with the use of antihypertensive medication. Accessibility Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. Accessibility ECG Challenge: What's Causing This Woman's Slow Pulse? An official website of the United States government. Agency for Healthcare Research and Quality (US), Rockville (MD). All information these cookies collect is aggregated and therefore anonymous. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. official website and that any information you provide is encrypted First, a health care professional wraps an inflatable cuff around your arm. Archived: This report is greater than 3 years old. Page originally created December 2020. 7 HBPM is also known as self-measured BP. No studies evaluated children. In total, 49 studies met eligibility criteria. This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. 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. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. Effective Health Care Program . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Other factors that can improve accuracy include the use of an appropriately sized cuff and slow cuff deflation. Please confirm that you would like to log out of Medscape. OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . Addressing Barriers Beyond the Published Literature Please enable it to take advantage of the complete set of features! Figure 2. Bethesda, MD 20894, Web Policies 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. Your feet should be flat on the floor and your legs . 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. 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. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . Measurements may interfere with a patient's activity or sleep. This video from NACHC, showcases several community health centers work to implement SMBP monitoring programs in their clinics. For SMBP plus additional support versus SMBP alone or with less intense additional support, the strength of evidence is low, failing to support a difference in BP. The health care professional then inflates the cuff, which gently tightens on your arm. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. 0 5600 Fishers Lane There is insufficient evidence concerning predictors of SMBP adherence. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. Target: BP: Implement SMBP Careers. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension 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. This site needs JavaScript to work properly. Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. 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. 45. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Measuring your blood pressure is the only way to know whether you have high blood pressure. Bookshelf National Library of Medicine 5600 Fishers Lane Agency for Healthcare Research and Quality, Rockville, MD. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Rockville, MD: Agency for Healthcare Research and Quality. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. Uhlig K, Balk EM, Patel K, Ip S, Kitsios GD, Obadan NO, et al. For example, terminal digit preference (i.e., preference for 0, 5, and even numbers) and single number preference (i.e., preference for specific values such as 130/80 or 140/90 mmHg) can lead to inaccuracies in measurement readings and variability across observers.17,18 This can be prevented when machines provide readings automatically. Register for the Million HeartsSMBP Forum, an opportunity for clinical, public health, and community-based partners to exchange best and promising practices, identify solutions to common obstacles, and share resources to accelerate SMBP monitoring uptake. Saving Lives, Protecting People. U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening Ann Intern Med. Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. 8600 Rockville Pike 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 In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. 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. However, there is uncertainty about the appropriate home BP targets for guiding treatment decisions and whether these should be based on the same cut-points from clinic BP or from ABPM for defining hypertension.32. 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. Source:Centers for Disease Control and Prevention. Conclusions: There is no consensus on the precise protocol for SMBP monitoring in the management of hypertension regarding timing, frequency and duration. An official website of the Department of Health & Human Services, Internet Citation: 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] Uhlig K, Balk EM, Patel K, et al. 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Clinic measurements may not reflect the usual BP outside of the clinic setting throughout a day. Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. Home BP monitoring (HBPM) has been utilized for regular monitoring of BP at home to improve HTN control or regulate antihypertensive medications. We take your privacy seriously. You will receive email when new content is published. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. 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. This 2012 AHRQ review examined the comparative effectiveness of SMBP alone, of SMBP plus additional clinical support, and of usual care. 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. The goals of this report, therefore, are to inform physicians' decision whether to encourage the use of SMBP monitoring alone or along with additional support and to assist health care policymakers and payers with decisions regarding coverage and promotion of SMBP monitoring. Please enter a Recipient Address and/or check the Send me a copy checkbox. 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. Allison Goldstein, MPH, This website requires cookies, and the limited processing of your personal data in order to function. In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? Comparative Effectiveness Review Number 45 Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Executive Summary Background High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. sharing sensitive information, make sure youre on a federal For SMBP plus additional support versus SMBP alone or with less intense additional support, the strength of evidence is low, failing to support a difference in BP. They can help you make a plan to manage high blood pressure. Prior to joining CDC, Allison worked on the Global Polio Eradication Initiative at CARE International where she designed curricula for health workers and conducted evaluation field research on global polio eradication efforts. Allison is trained as an emergency medical technician and received a bachelor of science degree in biology and anthropology from the University of Michigan and a master of public health degree, with a focus in behavioral science and education, from Emory University. John M. Eisenberg Center for Clinical Decisions and Communications Science. 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. Would you like email updates of new search results? 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. 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. This report addresses questions regarding the clinical value of SMBP monitoring with or without additional support and what factors may predict adherence with SMBP monitoring. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.

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