dabl Educational Trust: Sphygmomanometers for Self-measurement of Blood Pressure, British Hypertension Society: Blood Pressure Monitors Validated for Home Use, AHRQ Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. An official website of the Department of Health & Human Services, Internet Citation: How does adherence with SMBP monitoring vary by patient factors? [3] (Figure 2). CDCs 6|18 Initiative: Accelerating Evidence into Action Hypertension often requires lifelong treatment. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. Data Synthesis: This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness To sign up for updates or to access your subscriberpreferences, please enter your contact information below. 12-EHC002-EF. Home BP monitoring (HBPM) has been utilized for regular monitoring of BP at home to improve HTN control or regulate antihypertensive medications. National Library of Medicine i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i Comparative Effectiveness Review No. Read the full Million Hearts Hypertension Control Change Package. Self-Measured Blood Pressure Monitoring . No studies of SMBP monitoring in children were identified. Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. 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. PDF Science-in-Brief Feature: Self-Measured Blood Pressure Monitoring - CDC 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. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. [3] (Figure 1). How do health care professionals measure my blood pressure? endstream endobj startxref The .gov means its official. include self-measured blood pressure monitoring (SMBP) plus additional clinical support and empowerment of non-physician clinicians (e.g. 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. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. If you are concerned about your blood pressure numbers, talk to your health care team. Figure 1. Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. All information these cookies collect is aggregated and therefore anonymous. 5600 Fishers Lane Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP Unable to load your collection due to an error, Unable to load your delegates due to an error, Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. How does SMBP monitoring compare with usual care or other interventions without SMBP in its effect on relevant clinical outcomes (cardiovascular events, mortality, patient satisfaction, quality of life, and adverse events related to antihypertensive agents)? To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. 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. How does SMBP monitoring compare with usual care or other interventions without SMBP in its effect on relevant surrogate outcomes (cardiac measures: LVH [left ventricular hypertrophy], LVM [left ventricular mass], LVMI [left ventricular mass index]) and intermediate outcomes (BP control, BP treatment adherence, or health care process measures)? A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. AHRQ Publication No. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. 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 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. 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. You can review and change the way we collect information below. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. Data Sources: Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. 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. Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers, Self-Measured Blood Pressure Monitoring: Comparative Effectiveness, https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure, Comment on Key Questions and Draft Reports, 25 Years of the AHRQ Evidence-based Practice Center Program, U.S. Department of Health & Human Services. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 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. Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] Introduction. 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. Impact of SelfMonitoring of Blood Pressure on Processes of This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. 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. 2012 Sep 21. 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. 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. Allison Goldstein, MPH, Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. Comparative Effectiveness Review No. Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure MeSH OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was . Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 7 HBPM is also known as self-measured BP. 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. 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. %PDF-1.6 % They help us to know which pages are the most and least popular and see how visitors move around the site. 5600 Fishers Lane If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. Measurements may interfere with a patient's activity or sleep. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Use this tool to keep track of your blood pressure measurements at home. Thus an alternative term for SMBP monitoring which better captures the application of self measurement for this report is the term home BP monitoring; however since the term is relatively rarely used in the literature, we will continue to use SMBP. CDC twenty four seven. Hello. Ann Intern Med. This site needs JavaScript to work properly. You will be subject to the destination website's privacy policy when you follow the link. 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. If you log out, you will be required to enter your username and password the next time you visit. This summary is provided to assist in clinical decisionmaking along with consideration of a patient's values and preferences. 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 (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control. Document author(s)/institution of origin: Effective Health Care Program, Agency for Healthcare Research and . Study Selection: PDF Science In Brief: Home and Online Management and Evaluation of Blood These cookies may also be used for advertising purposes by these third parties. Brown Affiliations All information these cookies collect is aggregated and therefore anonymous. 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. Background: 45. 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 Self-measured BP (SMBP) monitoring is another option that allows for more frequent measurements, and possibly more accurate readings of a patient's typical BP. 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 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. 45.) Self-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. You've successfully added to your alerts. SMBP monitoring is also commonly referred to as home blood pressure monitoring. Federal government websites often end in .gov or .mil. Public Information from the CDC and Medscape. Many studies were of moderate to poor quality and had short followup periods. There is insufficient evidence concerning predictors of SMBP adherence. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. Please enter a Recipient Address and/or check the Send me a copy checkbox. Measuring your blood pressure is the only way to know whether you have high blood pressure. Resources for Public Health Professionals, Improving Medication Adherence Among Patients with Hypertension, Hypertension Control Challenge Rules and Eligibility, Hypertension Control Champions Success Stories, Hospitals & Health Systems Recognition Program, Spotlight: NYC Health + Hospitals/Metropolitan, Spotlight: The Ohio State University and Wexner Medical Center, Spotlight: New Hanover Regional Medical Center, COVID-19 and Cardiovascular Disease Partner Toolkit, Heart-Healthy Steps Campaign Partner Toolkit, "Live to the Beat" Campaign Partner Toolkit, Self-Measured Blood Pressure (SMBP) Monitoring Implementation Toolkit [PDF - 2 MB], U.S. 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. AHRQ Publication No. 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. Thank you for taking the time to confirm your preferences. The https:// ensures that you are connecting to the The cuff has a gauge on it that will measure your blood pressure. Rockville, MD 20857 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. See the resources below for specific recommendations. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP monitoring. 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. This is an official U.S. government web site managed by the 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. 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. 8600 Rockville Pike What should I do if my blood pressure numbers are high? On the other hand, if more frequent home BP measurements lead to more encounters for counseling, modification of lifestyle behaviors, drug treatments along with management of adverse effects, SMBP may actually increase cost, at least in the short term, since it takes several years for improved BP control to improve clinical outcomes. Finally, SMBP may be useful in preventing overtreatment in individuals with white coat syndrome, orthostatic BP changes, or hypotensive episodes from medication. 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. The bold lines indicate the comparisons addressed in the Key Questions (see below). Clinic measurements may not reflect the usual BP outside of the clinic setting throughout a day. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. 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. They can help you make a plan to manage high blood pressure. Monitoring Your Blood Pressure at Home | American Heart Association 2012 Feb 15. Patient-provider feedback loop with clinical support for SMBP monitoring. We take your privacy seriously. 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. PMID: 23922064. You and your health care team can take steps to control your blood pressureif it is too high. HHS Vulnerability Disclosure, Help The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. 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. Thank you. How to Use Your Home Blood Pressure Monitor : 14-05204-EF-1. and transmitted securely. Saving Lives, Protecting People. Research shows that SMBP: Can improve adherence and health outcomes for hypertensive patients1 The HOME BP intervention for SMBP is an integrated patient-practitioner online digital tool. 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. Patients may require some instruction on how to use SMBP devices.30,31. 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.
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self measured blood pressure monitoring: comparative effectiveness