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. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. You will be subject to the destination website's privacy policy when you follow the link. Bethesda, MD 20894, Web Policies Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. official website and that any information you provide is encrypted Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. This 2021 recommendation from the USPSTF includes additional guidance for obtaining blood pressure measurements away from the clinical setting. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. Self-Blood Pressure Monitoring in an Urban, Ethnically Diverse Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. CDCs 6|18 Initiative: Accelerating Evidence into Action 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. Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers. For SMBP plus additional support versus SMBP alone or with less intense additional support, the strength of evidence is low, failing to support a difference in BP. Europe PMC is an archive of life sciences journal literature. To sign up for updates or to access your subscriberpreferences, please enter your email address below. PDF CER 45 Self-Measured Blood Pressure Monitoring Comparative This table from a 2021 Current Atherosclerosis Reports journal article features oscillometric blood pressure devices validated for accuracy during pregnancy. This feature requires the newest version of Flash. Page originally created December 2020. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Rockville, MD 20857 Bethesda, MD 20894, Web Policies 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. In otherwise healthy adults, hypertension is defined as a persistently elevated BP equal to or greater than 140/90 mmHg.1 The recommended BP measurement technique is to average two readings taken in a person after 5 minutes quietly seated in chair.1 In children, the diagnosis is made from an average of three or more BP readings greater than the 95th percentile for age, sex, and height.2,3 The Seventh Joint National Committee (JNC 7) guideline recommends a BP goal of 140/90 mmHg or less in the general population and a lower goal of 130/80 mmHg or less in patients with diabetes mellitus or chronic kidney disease.1. This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. As self-measurement requires patient participation, certain patient characteristics may affect compliance with SMBP monitoring, such as the willingness and ability to self-monitor BP and the technical literacy in operating the device or an interface for telemonitoring. This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. However, even when measured according to established guidelines, clinic BP measurements have several limitations. Unauthorized use of these marks is strictly prohibited. The HOME BP intervention for SMBP is an integrated patient-practitioner online digital tool. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. Prior to joining CDC, Allison worked on the Global Polio Eradication Initiative at CARE International where she designed curricula for health workers and conducted evaluation field research on global polio eradication efforts. This patient-friendly video from the Release the Pressure Coalition highlights the key steps people can take for accurate SMBP monitoring. Purpose: SMBP CPT Coding [PDF 1 MB] Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. There are also a variety of kiosks available in stores and pharmacies. Project Timeline. This site needs JavaScript to work properly. 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. The cuff has a gauge on it that will measure your blood pressure. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Content last reviewed March 2020. There is growing evidence that selfmonitoring of blood pressure (SMBP) with guided support beyond usual primary care improves BP control. 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). Thank you for taking the time to confirm your preferences. Ambulatory BP monitoring requires a technologist to program the machine, fit it on the patient, remove it and download the results and a physician to interpret them. Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. 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. John M Eisenberg Center for Clinical Decisions and Communications Science. 8600 Rockville Pike Hypertension often requires lifelong treatment. Murakami L, Rakotz M. Improving health outcomes: Blood pressure. We also included longitudinal cohort studies in addressing adherence predictors. Agency for Healthcare Research and Quality, Rockville, MD. Findings may be used for research purposes, but should not be considered current. Several national and international hypertension guidelines endorse self-measured BP monitoring. Rockville, MD 20857 The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Comparative Effectiveness Review Number 45 Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Executive Summary Background High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. Very few trials evaluated objective clinical outcomes. Patient-provider feedback loop with clinical support for 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. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. 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. Background Hypertension often requires lifelong treatment. Comparative Effectiveness Review No. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. The https:// ensures that you are connecting to the Self-Measured Blood Pressure Monitoring: Comparative Effectiveness This website also contains material copyrighted by 3rd parties. Take at least two readings, 1 or 2 minutes apart. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. January 2012 As they were scoping their work for SMBP, they started by searching multiple databases Bookshelf Document author(s)/institution of origin: Effective Health Care Program, Agency for Healthcare Research and . Click the topic below to receive emails when new articles are available. If you have high blood pressure, talk to your health care team about steps to take to control your blood pressureto lower your risk for heart disease and stroke. 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. Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence SMBP = self-measured BP; KQ = Key Question. : 12-EHC002-EF. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. Please enter a Recipient Address and/or check the Send me a copy checkbox. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure. 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 (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. Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association How to Use Your Home Blood Pressure Monitor AHRQ Publication No. Sit with your back straight and supported (on a dining chair, rather than a sofa). [3] (Figure 1). No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Hypertension often requires lifelong treatment. 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.) 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.
