self measured blood pressure monitoring: comparative effectiveness

A connected monitor is preprogrammed to regularly record BP, usually every 15 to 20 minutes while awake and every 20 to 30 minutes while asleep. Bookshelf 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. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Measurements can be read by a person or provided digitally by a device. 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. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure/research. These cookies may also be used for advertising purposes by these third parties. Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With A health care team member can show you how to use one if you need help. That the mean number of BP measurements recorded per week for users who continued recording blood pressure at 6 weeks was 6 compared to 8 among those who continued for at least 14 weeks, demonstrates high levels of engagement with respect to self-measured BP monitoring. 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. All information these cookies collect is aggregated and therefore anonymous. Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. %%EOF A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. government site. A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was more effective than usual care in improving blood pressure control among patients with hypertension. Unable to load your collection due to an error, Unable to load your delegates due to an error, Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. This 2020 AMA handout for Current Procedural Terminology (CPT) provides codes and descriptions for SMBP-related services. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. Purpose: Background: Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Aug. Report No. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Accessibility Current insurance coverage for SMBP plus clinical support is limited and improvements are planned or are under way. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. Very few trials evaluated objective clinical outcomes. government site. Introduction. The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels. Background Hypertension often requires lifelong treatment. The https:// ensures that you are connecting to the However, even when measured according to established guidelines, clinic BP measurements have several limitations. 0 Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Unauthorized use of these marks is strictly prohibited. Very few trials evaluated objective clinical outcomes. Unauthorized use of these marks is strictly prohibited. Patient-provider feedback loop.Source:Centers for Disease Control and Prevention. i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. 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. SMBP differs from clinic-based and ambulatory blood . Self-Measured Blood Pressure Monitoring: Comparative Effectiveness People using assistive technology may not be able to fully access information in these files. CDCs 6|18 Initiative: Accelerating Evidence into Action Content last reviewed August 2018. If you log out, you will be required to enter your username and password the next time you visit. Before 7 HBPM is also known as self-measured BP. sharing sensitive information, make sure youre on a federal 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. Apr 11, 2011. 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. Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Target: BP: Implement SMBP 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. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [PDF 1.2 MB] It predicted a rise by 24 percent in developed countries and 80 percent in developing countries by 2025.4 The World Health Report 2002 estimates that over 1 billion people have hypertension, which is estimated to cause 4.5 percent of the global disease burden.5 In addition, high BP directly results in 7 million deaths annually.6 Within the United States, about 76.4 million adults are affected.7 Data from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2008 indicated that 30 percent of all adults in the U.S. 18 years and older were hypertensive, with a higher prevalence among African Americans and the elderly.8 The prevalence of verified hypertension in children is more than 3 percent.2 A study from 2002 reported a lifetime risk of developing hypertension among adults aged 55 to 65 years in the U.S. as greater than 90 percent.9 Despite improvements in the quality of health care and life expectancy, it is expected that the prevalence of hypertension will continue to rise as the population ages. You will be subject to the destination website's privacy policy when you follow the link. This video from NACHC features DAngelo, a patient who explains how he has taken control of his blood pressure with the help of SMBP monitoring. 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. They help us to know which pages are the most and least popular and see how visitors move around the site. Please enter a Recipient Address and/or check the Send me a copy checkbox. This 2012 AHRQ review examined the comparative effectiveness of SMBP alone, of SMBP plus additional clinical support, and of usual care. Rockville, MD 20857 An official website of the United States government. 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. include self-measured blood pressure monitoring (SMBP) plus additional clinical support and empowerment of non-physician clinicians (e.g. J Athl Train. 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. Self-Measured Blood Pressure Monitoring . Findings may be used for research purposes, but should not be considered current. 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. Cookies used to make website functionality more relevant to you. 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. In that role, she provides scientific expertise to support research translation related to Million Hearts priority strategies. This article presents strategies for strengthening the United States ability to address hypertension in women focusing on pregnancy-related considerations for self-measured blood pressure monitoring. The HOME BP intervention for SMBP is an integrated patient-practitioner online digital tool. The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. PMID: 23922064. Archived: This report is greater than 3 years old. 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. Bethesda, MD 20894, Web Policies FOIA PDF Self-Measured Blood Pressure Monitoring - Centers for Disease Control Improving patient engagement in self-measured blood pressure monitoring No studies of SMBP monitoring in children were identified. 2011 Aug 8. The actual BP measurement can be done either by the patient, or less frequently by a companion, who is usually not a medical professional. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. 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. : 14-05198-EF-1. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. 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. Purpose Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. While patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of SMBP remains uncertain. 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. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Content last reviewed March 2020. This tool was developed by the National Association of Community Health Centers to help health care professionals compare blood pressure measurement devices from the U.S. Validated Device Listing across device features including cost, available cuff sizes, and data/technology capabilities. Ann Intern Med. . Impact of SelfMonitoring of Blood Pressure on Processes of May 28, 2010. In brief, ambulatory BP monitoring is a noninvasive, fully automated technique in which BP is recorded over an extended period of time, typically 24 hours. 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. Division for Heart Disease and Stroke Prevention. This 2020 joint policy statement from the American Heart Association (AHA) and the AMA addresses barriers to implementing SMBP monitoring. 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. In a comparative effectiveness review supported by the Agency for . Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Effectiveness of Self-Measured Blood Pressure Monitoring in - PubMed Effective Health Care Program . 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. In total, 49 studies met eligibility criteria. MeSH Addressing Barriers Beyond the Published Literature 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. Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. January 2012 As they were scoping their work for SMBP, they started by searching multiple databases [3] (Figure 2). : 14-05204-EF-1. These blood pressure monitors are easy and safe to use. : 13-05194-EF-1. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. How can I measure my blood pressure at home? Please confirm that you would like to log out of Medscape. Research shows that SMBP: Can improve adherence and health outcomes for hypertensive patients1 In studies of SMBP monitoring, how does achieving BP control relate to clinical and surrogate outcomes? For additional assistance, please contact us. CDC twenty four seven. Data extraction Data on . For SMBP plus additional support versus usual care, the strength of evidence is high and supports a lower BP with SMBP use (SBP/DBP -3.4 to -8.9/-1.9 to -4.4 mmHg) up to 12 months. Document author(s)/institution of origin: Effective Health Care Program, Agency for Healthcare Research and Quality, Internet Citation: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension. 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. In total, 49 studies met eligibility criteria. Is immediate imaging important in managing low back pain? HHS Vulnerability Disclosure, Help Ann Intern Med. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. b W 35D43zi&J &lbP K 7X Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. Clipboard, Search History, and several other advanced features are temporarily unavailable. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. Centers for Disease Control and Prevention. 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. All information these cookies collect is aggregated and therefore anonymous. Other factors that can improve accuracy include the use of an appropriately sized cuff and slow cuff deflation. 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.) The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Federal government websites often end in .gov or .mil. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness, https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure/research, Comment on Key Questions and Draft Reports, 25 Years of the AHRQ Evidence-based Practice Center Program, Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis, Postpartum Home Blood Pressure Monitoring, Postpartum Treatment of Hypertensive Disorders of Pregnancy, and Peripartum Magnesium Sulfate Regimens for Preeclampsia With Severe Features, Cervical Ripening in the Outpatient Setting, Sodium and Potassium Intake: Effects on Chronic Disease Outcomes and Risks, Effects of Dietary Sodium and Potassium Intake on Chronic Disease Outcomes and Related Risk Factors, U.S. Department of Health & Human Services. Hypertension also imposes a heavy financial burden on society at large. Rockville, MD: Agency for Healthcare Research and Quality. SMBP monitoring is also commonly referred to as home blood pressure monitoring. You can review and change the way we collect information below. %PDF-1.6 % Disclaimer. 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. This resource from the Public Health Informatics Institute provides a checklist of helpful characteristics for SMBP telemonitoring software. 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? 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. This feature requires the newest version of Flash. However, there is uncertainty about the appropriate home BP targets for guiding treatment decisions and whether these should be based on the same cut-points from clinic BP or from ABPM for defining hypertension.32. You will be subject to the destination website's privacy policy when you follow the link. Obtaining Adequate Fixation in a Periprosthetic Humerus Fracture Around a Shoulder Arthroplasty Stem in 81-Year-Old Man, ECG Challenge: Irregular Pulse During Cardiology Visit. This patient-friendly video from the Release the Pressure Coalition highlights the key steps people can take for accurate SMBP monitoring. Self-Measured Blood Pressure: Future Research Needs: Identification of 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. Untreated or ineffectively treated hypertension leads to increased cardiovascular morbidity and mortality in individuals, increased consumption of health care resources, high financial and human costs to society. Study Selection: SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. To sign up for updates or to access your subscriberpreferences, please enter your email address below. 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. Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy [PDF 441 KB] 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. Hello. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 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. Measurements may interfere with a patient's activity or sleep. 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. An official website of the Department of Health & Human Services. Careers. 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. Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. 8600 Rockville Pike This AMAAHA joint initiative can help health care professionals launch an SMBP monitoring program. 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. 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. hb```f`` & B,@Q+g~ 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. What you need to know about self-measured blood pressure monitoring Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. (Prepared by the Tufts Evidence-based Practice Center under Contract No. An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring 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. Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. 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. [3] (Figure 1). This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. Before European Associations Review Dietary Therapies for Obesity, AHA Statement Ranks 10 Popular Diets for Heart Health. Figure 1. Patient-provider feedback loop with clinical support for SMBP monitoring. 45. PDF CER 45 Self-Measured Blood Pressure Monitoring Comparative 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)? Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]. 1, 2 The TASMINH (Telemonitoring And SelfManagement in the Control of Hypertension) trials demonstrated that SMBP plus support, including telemonitoring (remotely monitoring patients using communication There are two BP monitoring strategies that can currently be used at home: Ambulatory and SMBP monitoring. PMC Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians [PDF 947 KB] Cite this: Self-Measured Blood Pressure Monitoring to Control Hypertension-Medscape-May06,2013. Source:Centers for Disease Control and Prevention. Self-Measured Blood Pressure Monitoring at Home: A Joint Policy These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. We take your privacy seriously. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. This one-page overview outlines the viability, costs, and returns for implementing an SMBP monitoring program based on Medicare reimbursement.

2021 Custom Farm Rates, Annalee Thomas Oregon, Santa Clara County Court Case Lookup, Jessa Seewald Children's Birthdays, Annapolis Md Drug Bust 2020, Articles S