Self-Measured Blood Pressure Monitoring . Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Data extraction Data on . Centers for Disease Control and Prevention. An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring Limitations: You will receive email when new content is published. 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. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care, Agency for Healthcare Research and Quality (US). 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. Purpose: To systematically review the trial evidence on the comparative effectiveness of hypertension management with versus without SMBP monitoring, and of different additional support interventions with SMBP. Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. PMID: 23922064. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. Project Timeline. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness There is insufficient evidence concerning predictors of SMBP adherence. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. pressure monitoring and refers to the regular use of a The bold lines indicate the comparisons addressed in the Key Questions (see below). https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html. Content last reviewed August 2018. Measure your blood pressure regularly to help your health care team diagnose any health problems early. Why do I need to measure my blood pressure? If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Ann Intern Med. Accessibility Lozano P, Henrikson NB, Morrison CC, Dunn J, Nguyen M, Blasi P, Whitlock EP. Uhlig K, Balk EM, Patel K, et al. CDC twenty four seven. Given clinical heterogeneity and limited head to head comparisons, the evidence limits our ability to draw definitive conclusions about the incremental effect of any specific additional support. SMBP = self-measured BP; KQ = Key Question The figure shows a schematic of possible comparisons between SMBP, SMBP plus additional, support without (more), In light of the potential health care benefits and knowledge gaps highlighted above, a topic titled Self Blood Pressure Monitoring was developed through the processes of topic identification, selection, and refinement for Comparative Effectiveness Review (CER) within the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care program.34. is a member of the Million Hearts Science team with the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention. Further debate focuses on the role of additional support needed to enhance adherence with SMBP monitoring and, possibly, achieve the clinical benefit from it. They help us to know which pages are the most and least popular and see how visitors move around the site. SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. 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. These include ambulatory BP monitoring (ABPM), self monitoring (or self measurement or home based) BP which is usually done by the patient at home, at work, or in any conducive environment. Today, as part of the CDC Expert Commentary Series on Medscape, I would like to talk about self-measured blood pressure (SMBP) monitoring plus clinical support as a way to help patients manage their hypertension. Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. Disclaimer. Tools to Establish a Self-Measured BP (SMBP) Monitoring Program [PDF 2 MB] 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 clinic 26 MeSH There is within-individual biological variability as well as measurement error. Hypertension is a major risk factor for cardiovascular disease and mortality and accounts for an estimated 14 percent of cardiovascular deaths worldwide and 18 percent in developed countries.10 It is an important modifiable risk factor for coronary artery disease, stroke, chronic kidney disease, congestive heart failure, and peripheral vascular disease.1 The World Health Organization ranks high BP as the third highest risk factor for burden of disease, after underweight and unsafe sex, highlighting the contribution of hypertension directly and indirectly to the development of numerous diseases.5. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension. Bethesda, MD 20894, Web Policies This table from a 2021 Current Atherosclerosis Reports journal article features oscillometric blood pressure devices validated for accuracy during pregnancy. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. 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). Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 7 HBPM is also known as self-measured BP. 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. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. 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. 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]. Federal government websites often end in .gov or .mil. A health care team member can show you how to use one if you need help. Hypertension often requires lifelong treatment. 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. High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]. Before Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Cookies used to make website functionality more relevant to you. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. Bookshelf 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. 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. These cookies may also be used for advertising purposes by these third parties. Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. Rockville, MD: Agency for Healthcare Research and Quality. Take at least two readings, 1 or 2 minutes apart. 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. Background Hypertension often requires lifelong treatment. Out-of-Office Blood Pressure Monitoring: A Comparison of Ambulatory How to Use Your Home Blood Pressure Monitor Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [PDF 1.2 MB] Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Division for Heart Disease and Stroke Prevention. 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. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Dec. Report No. Purpose: 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. First, a health care professional wraps an inflatable cuff around your arm. SMBP = self-measured BP; KQ = Key Question. CDCs 6|18 Initiative: Accelerating Evidence into Action 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. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] Data Synthesis: 45. ECG Challenge: What's Causing This Woman's Slow Pulse? Topic Initiated. Many SMBP devices are commercially available. Data Sources: This video from NACHC, showcases several community health centers work to implement SMBP monitoring programs in their clinics. You've successfully added to your alerts. Findings may be used for research purposes, but should not be considered current. 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. To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. Finally, SMBP may be useful in preventing overtreatment in individuals with white coat syndrome, orthostatic BP changes, or hypotensive episodes from medication. Improving patient engagement in self-measured blood pressure monitoring To summarize evidence about the effectiveness of self-measured blood pressure (SMBP) monitoring in adults with hypertension. Unauthorized use of these marks is strictly prohibited. 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. Generally, individuals with hypertension would use such devices at home to measure their own BP and provide written lists of readings to their provider at office visits. Public Information from the CDC and Medscape. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. 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. To systematically review the trial evidence on the comparative effectiveness of hypertension management with versus without SMBP monitoring, and of different additional support interventions with SMBP. These blood pressure monitors are easy and safe to use. You will be subject to the destination website's privacy policy when you follow the link. 293 0 obj <> endobj 12-EHC002-EF. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Research Protocol . The .gov means its official. J Athl Train. Use this tool to keep track of your blood pressure measurements at home. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Associate Director, Center for Health Services Research in Primary Care Durham Veterans Affairs Medical Center We also included longitudinal cohort studies in addressing adherence predictors. While patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of SMBP remains uncertain.
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