Updated Hypertension Guidelines: Implications for Treatment? hb```f`` & B,@Q+g~ 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. 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. There is insufficient evidence concerning predictors of SMBP adherence. (Prepared by the Tufts Evidence-based Practice Center under Contract No. Taking Control of My Blood Pressure: DAngelos Story The .gov means its official. 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. These types of minimally intensive approaches are important to test in all populations, especially those experiencing related health disparities, for broad implementation with . 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. Systematic Review: Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] Federal government websites often end in .gov or .mil. How do health care professionals measure my blood pressure? 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. If you are concerned about your blood pressure numbers, talk to your health care team. You can review and change the way we collect information below. Clinical support includes regular one-on-one counseling, web-based or telephonic support tools, and educational classes. 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. How do different devices for SMBP monitoring compare with each other (specifically semiautomatic or automatic versus manual) in their effects on clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence)? People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure. In total, 49 studies met eligibility criteria. Empty your bladder and ensure at least 5 minutes of quiet rest before measurements. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. How does adherence with SMBP monitoring vary by patient factors? J Athl Train. Bethesda, MD 20894, Web Policies 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. For appropriate diagnosis and therapy, accurate BP measurement is of great importance. The HOME BP intervention for SMBP is an integrated patient-practitioner online digital tool. Measure your blood pressure regularly to help your health care team diagnose any health problems early. 0 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. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. [1] SMBP monitoring plus clinical support has been found to be effective in helping patients control their blood pressure.[2]. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. 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). Centers for Disease Control and Prevention. 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. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. If you log out, you will be required to enter your username and password the next time you visit. A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was . >gL/?eEAV c,1t D~ 8-?x}0 KQUo~TJa&A6@sY(|x D G&pA32^Y|VLEcx 71HbFFhi3"9#+Z~GqESHm,Y-G1. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Regardless of the mode of support delivered, the patient-provider feedback loop is essential. Agency for Healthcare Research and Quality, Rockville, MD. This patient-friendly video from NACHC outlines clear instructions for using home blood pressure monitors. 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. Take at least two readings, 1 or 2 minutes apart. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. An official website of the United States government. Document author(s)/institution of origin: Effective Health Care Program, Agency for Healthcare Research and . 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. 52 prospective comparative studies of SMBP monitoring with or without additional support versus usual care or an alternative SMBP monitoring intervention in persons with hypertension. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. 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. 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. 5600 Fishers Lane 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. Federal government websites often end in .gov or .mil. This site needs JavaScript to work properly. SMBP monitoring is also commonly referred to as home blood pressure 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. In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? No studies of SMBP monitoring in children were identified. An official website of the Department of Health and Human Services, Latest available findings on quality of and access to health care. You will be subject to the destination website's privacy policy when you follow the link. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. Where can I get my blood pressure checked? Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. People using assistive technology may not be able to fully access information in these files. Bookshelf Blood Pressure Validated Device Listing (VDL), Self-Measurement: How Patients and Care Teams Are Bringing Blood Pressure to Control, An Economic Case for Self-Measured Blood Pressure (SMBP) Monitoring [PDF - 156 KB], Choosing-a-Home-BP-Monitor At-a-Glance-Comparison, Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis, Tools to Establish a Self-Measured BP (SMBP) Monitoring Program, Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement, Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy, Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure, Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians, Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring, Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP) Through Clinical-Community Care Models, Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners, Topline Findings: A National Analysis of Self-Measured Blood Pressure Monitoring Coverage and Reimbursement, CDCs 6|18 Initiative: Accelerating Evidence into Action, Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video, How to Use Your Home Blood Pressure Monitor, Taking Control of My Blood Pressure: DAngelos Story, Taking Control of My Blood Pressure: Natalias Story, How to Measure Your Blood Pressure at Home, The Correct Way to Measure Blood Pressure, How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States? While patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of SMBP remains uncertain. 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. 293 0 obj <> endobj Disclaimer. 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. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. 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. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence
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