self measured blood pressure monitoring: comparative effectiveness

In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Patients may require some instruction on how to use SMBP devices.30,31. You've successfully added to your alerts. official website and that any information you provide is encrypted Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. (Prepared by the Tufts Evidence . Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]. The cost of a home BP monitor ranges between $40 to $150, and the insurance coverage and approval for these devices vary across states.33 However, provision of the device could be cost-saving if it resulted in a reduced number of office visits for BP measurement or management or resulted in improved BP, which could translate into reduced morbidity and health care utilization. This 2020 AMA handout for Current Procedural Terminology (CPT) provides codes and descriptions for SMBP-related services. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. 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. 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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 (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. Balk, Ethan - Brown University Internet Citation: Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. This video from the NACHC features Natalia, a patient who explains how she has taken control of her blood pressure with SMBP monitoring. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; 2012. The bold lines correspond to the comparisons covered in this report: SMBP versus usual care (Key Question 1, part 1); SMBP plus additional support versus support without SMBP (also Key Question 1, part 1); SMBP plus additional support versus usual care (Key Question 1, part 2); SMBP plus additional support versus SMBP (Key Question 2). January 2012 As they were scoping their work for SMBP, they started by searching multiple databases Addressing Barriers Beyond the Published Literature, Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association, An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring, Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness, U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening, Division for Heart Disease and Stroke Prevention, Live to the Beat Campaign Partner Toolkit. Home BP monitoring (HBPM) has been utilized for regular monitoring of BP at home to improve HTN control or regulate antihypertensive medications. HHS Vulnerability Disclosure, Help 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. This list of resources from the Million Hearts Hypertension Control Change Package can help assign care team roles for an SMBP monitoring program and guide patients on selecting a home blood pressure monitor. They help us to know which pages are the most and least popular and see how visitors move around the site. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. Numerous health professional and government organizations have developed various guidelines for BP management. Measuring your blood pressure is the only way to know whether you have high blood pressure. Improving patient engagement in self-measured blood pressure monitoring https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. government site. Sit correctly. PDF CER 45 Self-Measured Blood Pressure Monitoring Comparative 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. 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. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. : 14-05204-EF-1. Show details Contents < Prev Next > Key Informants Susan Booth Project Leader, Personal Care & Wellness Consumer Reports Yonkers, NY Hayden Bosworth, Ph.D. 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. Cookies used to make website functionality more relevant to you. These blood pressure monitors are easy and safe to use. Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy [PDF 441 KB] The Community Preventive Services Task Force (CPSTF) Recommendations on Self-Measured Blood Pressure Monitoring Interventions You and your health care team can take steps to control your blood pressureif it is too high. 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. We take your privacy seriously. 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. SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. Please enable it to take advantage of the complete set of features! For additional assistance, please contact us. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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. Measure Your Blood Pressure | cdc.gov CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. PDF Background Effective Health Care Program - Agency for Healthcare 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. 2011 Aug 8. 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? Taking Control of My Blood Pressure: DAngelos Story This website also contains material copyrighted by 3rd parties. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] Data Sources: Accessibility Rockville, MD 20857 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. There is growing evidence that selfmonitoring of blood pressure (SMBP) with guided support beyond usual primary care improves BP control. A health care team member can show you how to use one if you need help. Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. and transmitted securely. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP monitoring. 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 process is quick and painless. Background: These include ambulatory BP monitoring (ABPM), self monitoring (or self measurement or home based) BP which is usually done by the patient at home, at work, or in any conducive environment. To determine predictors of adherence with SMBP monitoring. E-mail questions about the Forum toMillionHeartsSMBP@nachc.com. Unauthorized use of these marks is strictly prohibited. PDF Science In Brief: Home and Online Management and Evaluation of Blood 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. A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Readings by a person can be affected by observer training, preference, and bias. SMBP monitoring can provide more frequent BP readings and if these are transmitted back to the provider, they can be used for more rapid and frequent adjustments in blood pressure medication to ensure adequate BP control. Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . Very few trials evaluated objective clinical outcomes. 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. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? What should I do if my blood pressure numbers are high? Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. The health care professional then inflates the cuff, which gently tightens on your arm. 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. Figure 1. Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. Regardless of the mode of support delivered, the patient-provider feedback loop is essential. To summarize evidence about the effectiveness of self-measured blood pressure (SMBP) monitoring in adults with hypertension. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Dec. Report No. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. 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. Measurements can be read by a person or provided digitally by a device. pressure monitoring and refers to the regular use of a 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. For the purpose of this report, BP measurement by the patient in the office/clinic/pharmacy or a health unit at work is not included under SMBP monitoring since it does not reliably overcome the problem of white coat hypertension nor provide the privacy and opportunity for more frequent measurements of home self measurement. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. These cookies may also be used for advertising purposes by these third parties. hXio8EIbHr)_cBCq{(1KLL)}]IDb)Pb"VL *&DSK28ijMqXLG:a/^~ vs:?COe+Y1~504ye49ucTSQZGUI+'O+ {EQZu]`^.7t n\B^9~: OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . Please use this form to submit your questions or comments on how to make this article more useful to clinicians. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. SMBP CPT Coding [PDF 1 MB] Further debate focuses on the role of additional support needed to enhance adherence with SMBP monitoring and, possibly, achieve the clinical benefit from it. 45. Disclaimer. Clinic measurements may not reflect the usual BP outside of the clinic setting throughout a day. Page originally created December 2020. PMID: 23922064. [3] (Figure 2). Whether or not to advise the use of an SMBP monitoring device for a patient with hypertension is a common clinical question for clinicians. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. (Comparative Effectiveness Reviews, No. Internet Citation: 8600 Rockville Pike sX Ndb`T~ Data extraction Data on . b W 35D43zi&J &lbP K 7X Thank you for taking the time to confirm your preferences. No studies of SMBP monitoring in children were identified. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. A reading that says your blood pressure is higher than it actually is may lead to treatment you dont need. 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. The Forum convenes online quarterly. 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. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Centers for Disease Control and Prevention. Archived: This report is greater than 3 years old. Careers. The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. In total, 49 studies met eligibility criteria. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. 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.