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 website requires cookies, and the limited processing of your personal data in order to function. [1] SMBP monitoring plus clinical support has been found to be effective in helping patients control their blood pressure.[2]. OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . FOIA 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 (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. Read the full Million Hearts Hypertension Control Change Package. They help us to know which pages are the most and least popular and see how visitors move around the site. CER 45 Self-Measured Blood Pressure Monitoring Comparative Effectiveness Surveillance Final 4.7 AHRQ%Systematic%Review%% Surveillance%Program% CER$#45:$Self'Measured"Blood"Pressure"Monitoring:"$ Comparative"Effectiveness" Original$Release$Date:$nuary Ja "2012" Surveillance$Report: "vember"2012No " Surveillance$Report: "rchMa "2016"" 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. . This website also contains material copyrighted by 3rd parties. Source:Centers for Disease Control and Prevention. Study Selection: HHS Vulnerability Disclosure, Help Research shows that SMBP: Can improve adherence and health outcomes for hypertensive patients1 The .gov means its official. Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians [PDF 947 KB] Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . Effective BP control has been shown to decrease incidence for stroke by 35 to 40 percent, myocardial infarction by 20 to 25 percent, and heart failure more than 50 percent.11,12 Systematic reviews have also shown the beneficial effects of lowering BP on reducing fatal and nonfatal stroke, cardiac events, and total among individuals with severe hypertension or at increased risk (such as of older age or with other comorbid risk factors).11,13,14 A decrease of 5 mmHg in systolic BP has been estimated to result in a 14 percent overall reduction in mortality due to stroke, 9 percent reduction in mortality due to chronic heart disease and 7 percent reduction in all-cause mortality.1,15,16 However, long-term adherence to lifestyle modification and medication remains a challenge in the management of hypertension, which is usually a lifelong condition. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. National Library of Medicine An official website of the United States government. No studies evaluated children. 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. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. Content last reviewed March 2021. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. No studies evaluated children. 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. 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. There is insufficient evidence concerning predictors of SMBP adherence. 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. Lipid Screening in Childhood for Detection of Multifactorial Dyslipidemia: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. Measure your blood pressure regularly to help your health care team diagnose any health problems early. This SMBP coverage summary from the American Medical Association shows Medicaid coverage by state for automated SMBP blood pressure devices, standalone cuffs, and related clinical services. For additional assistance, please contact us. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Aug. Report No. Thank you for taking the time to confirm your preferences. 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. Empty your bladder and ensure at least 5 minutes of quiet rest before measurements. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. Self-Measured Blood Pressure Monitoring . %PDF-1.6 % I am Allison Goldstein from the Division for Heart Disease and Stroke Prevention at CDC. Thank you. 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. sharing sensitive information, make sure youre on a federal 45. Conclusions: Addressing Barriers Beyond the Published Literature 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). You and your health care team can take steps to control your blood pressureif it is too high. (Prepared by the Tufts Evidence . Several national and international hypertension guidelines endorse self-measured BP monitoring. SMBP Coverage Insights: Medicaid [PDF 232 KB] This video from the NACHC features Natalia, a patient who explains how she has taken control of her blood pressure with SMBP monitoring. To determine predictors of adherence with SMBP monitoring. This is an official U.S. government web site managed by the 2012 Sep 21. How to Use Your Home Blood Pressure Monitor Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. Measurements may interfere with a patient's activity or sleep. Research Protocol . Updated Hypertension Guidelines: Implications for Treatment? official website and that any information you provide is encrypted To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National . We take your privacy seriously. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. 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). Before 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. National Library of Medicine Ann Intern Med. Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring PMC The direct and indirect cost of high BP and its complications has been estimated at more than $43.5 billion in 2007 in the U.S.7 Thus, it cannot be viewed simply as an individual health issue given the large public health impact and the potential for cost savings with effective prevention or treatment. Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure. AHRQ Publication No. Hypertension often requires lifelong treatment. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. 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. Rockville, MD 20857 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. John M Eisenberg Center for Clinical Decisions and Communications Science. John M. Eisenberg Center for Clinical Decisions and Communications Science. 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. Limitations: This 2021 recommendation from the USPSTF includes additional guidance for obtaining blood pressure measurements away from the clinical setting. 5600 Fishers Lane Background Hypertension often requires lifelong treatment. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. 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. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. AHRQ Publication No. Associate Director, Center for Health Services Research in Primary Care Durham Veterans Affairs Medical Center European Associations Review Dietary Therapies for Obesity, AHA Statement Ranks 10 Popular Diets for Heart Health. Million Hearts Science team, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GeorgiaDisclosure: Allison Goldstein, MPH, has disclosed no relevant financial relationships. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. SMBP monitoring may not be suitable in certain patients, such as those with arrhythmias and ectopic beats, large arm circumferences (as a too-small cuff size may give falsely elevated BP readings), with physical or mental disabilities that interfere with device operation. 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. 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. Apr 11, 2011. Shareable Handouts and Tools in English and Spanish, steps to take to control your blood pressure, this list of questions to ask your health care team, take steps each day to help keep your blood pressure in a healthy range, Heart disease and stroke statistics-2020 update: a report from the American Heart Association, Sources of inaccuracy in the measurement of adult patients resting blood pressure in clinical settings: A systematic review, National Center for Chronic Disease Prevention and Health Promotion, 5 Surprising Facts About High Blood Pressure, Hypertension Statistical Reports for Health Professionals, Morbidity and Mortality Weekly Reports About Hypertension, Hypertension Resources for Health Professionals, U.S. Department of Health & Human Services. Taking Control of My Blood Pressure: Natalias Story Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. Share this graphic with family and friends to show them the correct way to measure blood pressure. To sign up for updates or to access your subscriberpreferences, please enter your email address below. This document provides action steps for public health practitioners to facilitate the implementation of SMBP monitoring plus additional support in five key areas: Understanding the environment; Working with payers and purchasers; Working with health care providers; Spreading the word to the public; and Monitoring/assessment of SMBP, plus additional support implementation. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. A BP cuff is placed around the upper arm and left in place for approximately 24 hours. Project Timeline. This patient-friendly video from the Release the Pressure Coalition highlights the key steps people can take for accurate SMBP monitoring. This AMAAHA joint initiative can help health care professionals launch an SMBP monitoring program. This toolkit, developed by the National Association of Community Health Centers (NACHC) for Million Hearts, can help organizations successfully integrate SMBP monitoring into care processes and workflows. 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. 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. This site needs JavaScript to work properly. Agency for Healthcare Research and Quality, Rockville, MD. You will be subject to the destination website's privacy policy when you follow the link. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. sX Ndb`T~ Measuring your blood pressure is the only way to know whether you have high blood pressure. Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care, Agency for Healthcare Research and Quality (US). These blood pressure monitors are easy and safe to use. Take your blood pressure at the same time every day. 12-EHC002-EF. 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. Accessibility There is growing evidence that selfmonitoring of blood pressure (SMBP) with guided support beyond usual primary care improves BP control. 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 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. Bookshelf How does SMBP monitoring compare with usual care or other interventions without SMBP in its effect on relevant clinical outcomes (cardiovascular events, mortality, patient satisfaction, quality of life, and adverse events related to antihypertensive agents)? To determine predictors of adherence with SMBP monitoring. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. These cookies may also be used for advertising purposes by these third parties. 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? Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. In total, 49 studies met eligibility criteria. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. CDC twenty four seven. Disclaimer. 2012 Mar 19. Given clinical heterogeneity and limited head to head comparisons, the evidence limits our ability to draw definitive conclusions about the incremental effect of any specific additional support. SMBP Health IT Checklist [PDF 136 KB]
Lonnie Williams Obituary,
Crackling When Breathing Out Covid,
Adopt A Giraffe Bracelet,
Articles S
