Lozano P, Henrikson NB, Morrison CC, Dunn J, Nguyen M, Blasi P, Whitlock EP. SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. 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. MeSH PDF Coffee Break 2019: Effectiveness and Economic Evidence of Self-Measured Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. Bookshelf 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. 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. Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure. 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. 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. Purpose: FOIA An official website of the Department of Health and Human Services, Latest available findings on quality of and access to health care. Findings may be used for research purposes, but should not be considered current. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Data extraction Data on . government site. Apr 11, 2011. This report from the Public Health Informatic Institute provides key findings from a national health information technology assessment on SMBP and identifies gaps, barriers, and recommendations to advance the collection, transfer, and use of patient-generated SMBP data to improve hypertension management. and transmitted securely. SMBP monitoring may be used as a tool for disease self-management and to improve adherence with lifestyle and diet modification, or with drug treatment. 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. Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP Rockville, MD 20857 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.) Why do I need to measure my blood pressure? Figure 1. and transmitted securely. include self-measured blood pressure monitoring (SMBP) plus additional clinical support and empowerment of non-physician clinicians (e.g. How do health care professionals measure my blood pressure? Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. Impact of SelfMonitoring of Blood Pressure on Processes of The review addressed SMBP monitoring performed by the patient or the patient's companion at home; it did not include monitoring done at the doctor's office, clinic, pharmacy, or health unit at work, nor did it include blood pressure (BP) monitoring done at home by nurses or other health care professionals. Hypertension also imposes a heavy financial burden on society at large. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. These cookies may also be used for advertising purposes by these third parties. Readings by a person can be affected by observer training, preference, and bias. government site. Topic Initiated. 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. This AMAAHA joint initiative can help health care professionals launch an SMBP monitoring program. These evidence-based action steps and resources, assembled by Million Hearts, can help practices implement SMBP monitoring. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. Would you like email updates of new search results? This video from NACHC, showcases several community health centers work to implement SMBP monitoring programs in their clinics. Repeated measurements are needed to facilitate accurate classification of patients. 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. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 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. 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. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. 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. 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. SMBP differs from clinic-based and ambulatory blood . To determine predictors of adherence with SMBP monitoring. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Would you like email updates of new search results? SMBP means you regularly use a personal blood pressure measurement device away from a doctor's office or hospitalusually at home. Click the topic below to receive emails when new articles are available. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. Self-Measured Blood Pressure Monitoring - Medscape What is the correct way to measure blood pressure? Patients may require some instruction on how to use SMBP devices.30,31. SMBP measurements can be obtained from the upper arm, wrist, or fingers (or, if necessary, the lower extremity); however, experts recommend the use of upper arm devices due to the lack of validation and the high number of inaccurate measurements from the wrist and finger devices.26-28 Models for SMBP devices range from mechanical aneroid gauges (sphygmomanometers), which require self-inflation and auscultation (manual devices), to manually-inflated sphygmomanometers with automatic displays (semiautomated devices), to fully automated configurations that automatically inflate the sphygmomanometer and measure the BP (automated devices). In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was . This website requires cookies, and the limited processing of your personal data in order to function. Target: BP: Implement SMBP One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. Thank you for taking the time to confirm your preferences. Centers for Disease Control and Prevention. Sit correctly. In total, 49 studies met eligibility criteria. 2012 Sep 21. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. (Comparative Effectiveness Reviews, No. 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. E-mail questions about the Forum toMillionHeartsSMBP@nachc.com. Regardless of the mode of support delivered, the patient-provider feedback loop is essential. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). John M Eisenberg Center for Clinical Decisions and Communications Science. y ^]J[_tFe^~4:;:Cxbh jXd%SElY*Oi1h{_DsnL 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. Thank you for taking the time to confirm your preferences. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Methods - Self-Measured Blood Pressure Monitoring: Comparative In studies of SMBP monitoring, how does achieving BP control relate to clinical and surrogate outcomes? Finally, SMBP may be useful in preventing overtreatment in individuals with white coat syndrome, orthostatic BP changes, or hypotensive episodes from medication. There is insufficient evidence concerning predictors of SMBP adherence. Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . Careers. 293 0 obj <> endobj There is within-individual biological variability as well as measurement error. Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . A BP cuff is placed around the upper arm and left in place for approximately 24 hours. The actual BP measurement can be done either by the patient, or less frequently by a companion, who is usually not a medical professional. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. Comparative Effectiveness Review No. Associate Director, Center for Health Services Research in Primary Care Durham Veterans Affairs Medical Center in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. Whether or not to advise the use of an SMBP monitoring device for a patient with hypertension is a common clinical question for clinicians. i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i A recent CDC study found that 67 million adult Americans have hypertension, and of those, 36 million are uncontrolled. The health care professional then inflates the cuff, which gently tightens on your arm. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP monitoring. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. 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: Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO. 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. Telephone: (301) 427-1364, Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension, https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html, AHRQ Publishing and Communications Guidelines, Evidence-based Practice Center (EPC) Reports, Healthcare Cost and Utilization Project (HCUP), AHRQ Quality Indicator Tools for Data Analytics, United States Health Information Knowledgebase (USHIK), AHRQ Informed Consent & Authorization Toolkit for Minimal Risk Research, Grant Application, Review & Award Process, Study Sections for Scientific Peer Review, Getting Recognition for Your AHRQ-Funded Study, AHRQ Research Summit on Diagnostic Safety, AHRQ Research Summit on Learning Health Systems, National Action Alliance To Advance Patient Safety, Blood Pressure Control Evidence and Resources, Cholesterol Management Evidence and Resources, Advancing Heart Health Research and Results, U.S. Department of Health & Human Services.

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