The figure shows a schematic of possible comparisons between SMBP, SMBP plus additional, support without SMBP, and usual care. To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National . 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. Tools to Establish a Self-Measured BP (SMBP) Monitoring Program [PDF 2 MB] [3] (Figure 2). 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.
Self-Measured Blood Pressure: Future Research Needs: Identification of How to Measure Your Blood Pressure at Home [PDF 255 KB] Take this form [PDF 105 KB]with you on your first blood pressure visit to record important blood pressure-related information. In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 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. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. 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. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope. hb```f`` & B,@Q+g~ official website and that any information you provide is encrypted Clipboard, Search History, and several other advanced features are temporarily unavailable. CDCs 6|18 Initiative: Accelerating Evidence into Action 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. How to Use Your Home Blood Pressure Monitor Unable to load your collection due to an error, Unable to load your delegates due to an error, Comparative Effectiveness Review Summary Guides for Clinicians [Internet].
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. National Library of Medicine 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. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. 12-EHC002-EF. Allison is trained as an emergency medical technician and received a bachelor of science degree in biology and anthropology from the University of Michigan and a master of public health degree, with a focus in behavioral science and education, from Emory University. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. We take your privacy seriously.
Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP Measuring your blood pressure is the only way to know whether you have high blood pressure. Background Hypertension often requires lifelong treatment. We take your privacy seriously. Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. PMC SMBP differs from clinic-based and ambulatory blood . 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. Allison Goldstein, MPH, For example it is unclear whether simply providing a device for SMBP will improve BP control or whether this needs to be combined with additional support such as the telemetric transmission of readings to a provider to allow more frequent titration of drugs, regular nursing contact, or other types of interactions with a provider regarding hypertension management. Saving Lives, Protecting People. The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. AHRQ Publication No. To summarize evidence about the effectiveness of self-measured blood pressure (SMBP) monitoring in adults with hypertension.
Effectiveness of Self-Measured Blood Pressure Monitoring in - PubMed 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. sX Ndb`T~
PDF Science-in-Brief Feature: Self-Measured Blood Pressure Monitoring - CDC 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). However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. John M Eisenberg Center for Clinical Decisions and Communications Science. Bethesda, MD 20894, Web Policies Accessibility 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)? The actual BP measurement can be done either by the patient, or less frequently by a companion, who is usually not a medical professional. Numerous health professional and government organizations have developed various guidelines for BP management. Lozano P, Henrikson NB, Morrison CC, Dunn J, Nguyen M, Blasi P, Whitlock EP. Figure 1. Source:Centers for Disease Control and Prevention. Careers. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. 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. 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. Why do I need to measure my blood pressure? Other factors that can improve accuracy include the use of an appropriately sized cuff and slow cuff deflation. An official website of the Department of Health & Human Services. Ann Intern Med. Patients may require some instruction on how to use SMBP devices.30,31. 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. 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. Choosing-a-Home-BP-Monitor At-a-Glance-Comparison [PDF 446 KB] In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. . This patient-friendly video from NACHC outlines clear instructions for using home blood pressure monitors. January 2012 As they were scoping their work for SMBP, they started by searching multiple databases
Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Brown Affiliations There are also a variety of kiosks available in stores and pharmacies. A health care team member can show you how to use one if you need help. The https:// ensures that you are connecting to the 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. The full report, listing all studies, is available at www.effectivehealthcare.ahrq.gov/selfmeasuredbp.cfm. U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening Resources for Public Health Professionals, Improving Medication Adherence Among Patients with Hypertension, Hypertension Control Challenge Rules and Eligibility, Hypertension Control Champions Success Stories, Hospitals & Health Systems Recognition Program, Spotlight: NYC Health + Hospitals/Metropolitan, Spotlight: The Ohio State University and Wexner Medical Center, Spotlight: New Hanover Regional Medical Center, COVID-19 and Cardiovascular Disease Partner Toolkit, Heart-Healthy Steps Campaign Partner Toolkit, "Live to the Beat" Campaign Partner Toolkit, Self-Measured Blood Pressure (SMBP) Monitoring Implementation Toolkit [PDF - 2 MB], U.S. 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.) 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. Research shows that SMBP: Can improve adherence and health outcomes for hypertensive patients1
Self-Measured Blood Pressure Monitoring: Comparative Effectiveness The CDC 6|18 Initiative supports providing access for SMBP monitoring for home use and creating individual, provider, and health system incentives for compliance and meeting goals. 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. 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. Many studies were of moderate to poor quality and had short followup periods. Bethesda, MD 20894, Web Policies Please enter a Recipient Address and/or check the Send me a copy checkbox. Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. Please enable it to take advantage of the complete set of features! 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.
PDF Self-measured BP monitoring - American Medical Association 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. There is within-individual biological variability as well as measurement error. This feature requires the newest version of Flash. Content last reviewed March 2021. The health care professional then inflates the cuff, which gently tightens on your arm. All information these cookies collect is aggregated and therefore anonymous. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Self Measured Blood Pressure Monitoring (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control. Many studies were of moderate to poor quality and had short followup periods. Screening for High Blood Pressure in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. An official website of the United States government. With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. The Forum convenes online quarterly. You can review and change the way we collect information below. The Community Preventive Services Task Force (CPSTF) Recommendations on Self-Measured Blood Pressure Monitoring Interventions Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. Thank you for taking the time to confirm your preferences. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] However, consistently attaining reliable BP measurements is problematic. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. This 2021 recommendation from the USPSTF includes additional guidance for obtaining blood pressure measurements away from the clinical setting. Thank you for taking the time to confirm your preferences. In total, 49 studies met eligibility criteria. . CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
Improving patient engagement in self-measured blood pressure monitoring SMBP Coverage Insights: Medicaid [PDF 232 KB]
Monitoring Your Blood Pressure at Home | American Heart Association Self-Measured Blood Pressure Monitoring - Medscape Please confirm that you would like to log out of Medscape. 2012 Mar 19. Internet Citation: 5600 Fishers Lane 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. Hypertension Medication for Specific Comorbidities, Individualized Weight Monitoring Using the Heartphone, Home Blood Pressure Monitoring in Patients With Hypertension. PMID: 23922064. SMBP Health IT Checklist [PDF 136 KB] endstream
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May 28, 2010. 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. Findings may be used for research purposes, but should not be considered current. To determine predictors of adherence with SMBP monitoring. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. (Comparative Effectiveness Reviews, No. Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. 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.
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Systematic Review: Rockville, MD: Agency for Healthcare Research and Quality.
Self-Measured Blood Pressure Monitoring | Million Hearts We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. SMBP CPT Coding [PDF 1 MB] No studies evaluated children. sharing sensitive information, make sure youre on a federal 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. 0
Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; 2012. 5600 Fishers Lane 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. The https:// ensures that you are connecting to the pressure monitoring and refers to the regular use of a Regardless of the mode of support delivered, the patient-provider feedback loop is essential. Take at least two readings, 1 or 2 minutes apart. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. All information these cookies collect is aggregated and therefore anonymous. Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. 2012 Feb 15. If you are concerned about your blood pressure numbers, talk to your health care team. (Prepared by the Tufts Evidence-based Practice Center under Contract No. This website also contains material copyrighted by 3rd parties. In a comparative effectiveness review supported by the Agency for .
PDF Coffee Break 2019: Effectiveness and Economic Evidence of Self-Measured In addition, ambulatory BP monitoring is often used in research studies as an outcome, since many consider it to be more accurate than clinic-based BP measurement. They help us to know which pages are the most and least popular and see how visitors move around the site. Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. This is an official U.S. government web site managed by the
Associate Director, Center for Health Services Research in Primary Care Durham Veterans Affairs Medical Center Strong scientific evidence shows that self-measured blood pressure (SMBP) monitoring, also known as home blood pressure monitoring, plus clinical support helps people with hypertension lower their blood pressure. The cuff has a gauge on it that will measure your blood pressure. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. He has led the Evidence Review Teams for numerous guidelines for management of kidney disease, gynecological surgery, orthopedic surgery, and triaging in resource-poor countries. 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. Empty your bladder and ensure at least 5 minutes of quiet rest before measurements. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness.
Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Centers for Disease Control and Prevention.
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