Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. In that role, she provides scientific expertise to support research translation related to Million Hearts priority strategies. Progestogens for Prevention of Preterm Birth. To determine predictors of adherence with SMBP monitoring. MEDLINE, Cochrane Central Register of Controlled Trials, existing systematic and narrative reviews, recent conference proceedings, and the Food and Drug Administration. Empty your bladder and ensure at least 5 minutes of quiet rest before measurements. To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. 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. 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. pressure monitoring and refers to the regular use of a First, a health care professional wraps an inflatable cuff around your arm. A reading that says your blood pressure is higher than it actually is may lead to treatment you dont need. hXio8EIbHr)_cBCq{(1KLL)}]IDb)Pb"VL *&DSK28ijMqXLG:a/^~ vs:?COe+Y1~504ye49ucTSQZGUI+'O+ {EQZu]`^.7t n\B^9~: The site is secure. Piper MA, Evans CV, Burda BU, Margolis KL, OConnor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP. Effective Health Care Program . 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. The HOME BP intervention for SMBP is an integrated patient-practitioner online digital tool. Screening for High Blood Pressure in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. 2012 Feb 15. Unauthorized use of these marks is strictly prohibited. These blood pressure monitors are easy and safe to use. The figure shows a schematic of possible comparisons between SMBP, SMBP plus additional, support without SMBP, and usual care. i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i 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. HHS Vulnerability Disclosure, Help Archived: This report is greater than 3 years old. 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. Your feet should be flat on the floor and your legs . 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. Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring These types of minimally intensive approaches are important to test in all populations, especially those experiencing related health disparities, for broad implementation with . This 2020 AMA handout for Current Procedural Terminology (CPT) provides codes and descriptions for SMBP-related services. 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. This resource from the Public Health Informatics Institute provides a checklist of helpful characteristics for SMBP telemonitoring software. 7 HBPM is also known as self-measured BP. include self-measured blood pressure monitoring (SMBP) plus additional clinical support and empowerment of non-physician clinicians (e.g. Conclusions: 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. government site. Hypertension often requires lifelong treatment. : 12-EHC002-EF. The .gov means its official. No studies evaluated children. Several national and international hypertension guidelines endorse self-measured BP monitoring. This process is quick and painless. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. In total, 49 studies met eligibility criteria. 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. Hypertension Medication for Specific Comorbidities, Individualized Weight Monitoring Using the Heartphone, Home Blood Pressure Monitoring in Patients With Hypertension. Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No. 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. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Self-Measured Blood Pressure Monitoring Definition and Indications SMBP plus additional clinical support is one alternative to traditional oce care that could improve access to care and quality of care for individuals with hypertension while making blood pressure control more convenient and accessible across the population. See the resources below for specific recommendations. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; 2012. Division for Heart Disease and Stroke Prevention. In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? Is immediate imaging important in managing low back pain? 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 trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. : 13-05194-EF-1. Technically, SMBP monitoring refers to regular measurement by the patient of his or her own BP. FOIA Please enable it to take advantage of the complete set of features! Readings by a person can be affected by observer training, preference, and bias. Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy [PDF 441 KB] Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. 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. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. 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. January 2012 As they were scoping their work for SMBP, they started by searching multiple databases Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. 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? Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. The site is secure. Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care, Agency for Healthcare Research and Quality (US). [3] (Figure 2). FOIA Whether or not to advise the use of an SMBP monitoring device for a patient with hypertension is a common clinical question for clinicians. You will be subject to the destination website's privacy policy when you follow the link. 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. With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. Patient-provider feedback loop with clinical support for SMBP monitoring. In a comparative effectiveness review supported by the Agency for . SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. Figure 1. Reliable clinic measurements require an adequate rest period prior to measurement in order to enhance the consistency of BP readings. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Allison Goldstein, MPH, We take your privacy seriously. Centers for Disease Control and Prevention. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. 12-EHC002-EF. government site. Read the full Million Hearts Hypertension Control Change Package. 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. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. 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. For example it is unclear whether simply providing a device for SMBP will improve BP control or whether this needs to be combined with additional support such as the telemetric transmission of readings to a provider to allow more frequent titration of drugs, regular nursing contact, or other types of interactions with a provider regarding hypertension management. 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. Tools to Establish a Self-Measured BP (SMBP) Monitoring Program [PDF 2 MB] We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. 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). These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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? 8600 Rockville Pike To determine predictors of adherence with SMBP monitoring. 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. Share this graphic with family and friends to show them the correct way to measure blood pressure. All information these cookies collect is aggregated and therefore anonymous. 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. This feature requires the newest version of Flash. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. Data Extraction: They help us to know which pages are the most and least popular and see how visitors move around the site. While patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of SMBP remains uncertain. This one-page overview outlines the viability, costs, and returns for implementing an SMBP monitoring program based on Medicare reimbursement. Internet Citation: Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. This video summarizes results from Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP) Through Clinical-Community Care Models article, which discusses a pilot project in nine community health centers across three states to increase the use of SMBP using a collaborative model with health centers, community organizations, and health departments. 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 Projects funded by the Patient-Centered Outcomes Research Trust Fund. Many SMBP devices are commercially available. Saving Lives, Protecting People. In total, 49 studies met eligibility criteria. 45. Research shows that SMBP: Can improve adherence and health outcomes for hypertensive patients1 These cookies may also be used for advertising purposes by these third parties. Patient-provider feedback loop.Source:Centers for Disease Control and Prevention. Measure your blood pressure regularly to help your health care team diagnose any health problems early. This 2021 recommendation from the USPSTF includes additional guidance for obtaining blood pressure measurements away from the clinical setting. Accessibility The https:// ensures that you are connecting to the Source:Centers for Disease Control and Prevention. 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. How can I measure my blood pressure at home? 8600 Rockville Pike Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Measurements can be read by a person or provided digitally by a device. Hypertension often requires lifelong treatment. 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. Many studies were of moderate to poor quality and had short followup periods. 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. Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO. Careers. 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. 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 Lipid Screening in Childhood for Detection of Multifactorial Dyslipidemia: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet].
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