Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Aug. Report No. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness SMBP differs from clinic-based and ambulatory blood . They can help you make a plan to manage high blood pressure. 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. January 2012 As they were scoping their work for SMBP, they started by searching multiple databases 343 0 obj <>stream Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Target: BP: Implement SMBP 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. Federal government websites often end in .gov or .mil. You will be subject to the destination website's privacy policy when you follow the link. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. A health care team member can show you how to use one if you need help. Very few trials evaluated objective clinical outcomes. Use this checklist: If you are keeping track of your blood pressure at home, use these additional tips. The Forum convenes online quarterly. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Internet Citation: Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. 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. An official website of the Department of Health and Human Services, Latest available findings on quality of and access to health care. Project Timeline. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. No studies evaluated children. Self-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. 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.) Take at least two readings, 1 or 2 minutes apart. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] 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? The bold lines indicate the comparisons addressed in the Key Questions (see below). government site. Further debate focuses on the role of additional support needed to enhance adherence with SMBP monitoring and, possibly, achieve the clinical benefit from it. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. (Comparative Effectiveness Reviews, No. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. There are two BP monitoring strategies that can currently be used at home: Ambulatory and SMBP monitoring. Bethesda, MD 20894, Web Policies Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association CDC twenty four seven. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure/research. Self-Measured Blood Pressure Monitoring - Medscape Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. Out-of-Office Blood Pressure Monitoring: A Comparison of Ambulatory >gL/?eEAV c,1t D~ 8-?x}0 KQUo~TJa&A6@sY(|x D G&pA32^Y|VLEcx 71HbFFhi3"9#+Z~GqESHm,Y-G1. HHS Vulnerability Disclosure, Help Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy [PDF 441 KB] Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness 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. 12-EHC002-EF. hXio8EIbHr)_cBCq{(1KLL)}]IDb)Pb"VL *&DSK28ijMqXLG:a/^~ vs:?COe+Y1~504ye49ucTSQZGUI+'O+ {EQZu]`^.7t n\B^9~: The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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. 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. We also included longitudinal cohort studies in addressing adherence predictors. 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. 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). Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. The figure shows a schematic of possible comparisons between SMBP, SMBP plus additional, support without SMBP, and usual care. 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. (Prepared by the Tufts Evidence . Please enter a Recipient Address and/or check the Send me a copy checkbox. Measurements may interfere with a patient's activity or sleep. %PDF-1.6 % Ann Intern Med. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Centers for Disease Control and Prevention. Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. 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. endstream endobj 294 0 obj <>/Metadata 50 0 R/Names 317 0 R/Outlines 332 0 R/PageMode/UseOutlines/Pages 291 0 R/StructTreeRoot 110 0 R/Type/Catalog/ViewerPreferences<>>> endobj 295 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/StructParents 0/Tabs/S/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 296 0 obj <>stream Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers. John M Eisenberg Center for Clinical Decisions and Communications Science. Whether or not to advise the use of an SMBP monitoring device for a patient with hypertension is a common clinical question for clinicians. 8. Apr 11, 2011. Please enable it to take advantage of the complete set of features! 45. The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . Share this graphic with family and friends to show them the correct way to measure blood pressure. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Uhlig K, Balk EM, Patel K, et al. hbbd```b``A$ug`rX|" o/XDLHp0{W$5)"30^` w Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html. i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. 293 0 obj <> endobj 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. Disclaimer. official website and that any information you provide is encrypted 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. Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. The actual BP measurement can be done either by the patient, or less frequently by a companion, who is usually not a medical professional. Cookies used to make website functionality more relevant to you. National Library of Medicine We take your privacy seriously. Thank you for taking the time to confirm your preferences. Providers can help with SMBP implementation by promoting SMBP to their hypertensive patients and establishing clinical feedback systems. pressure monitoring and refers to the regular use of a 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. 2011 Aug 8. Hypertension also imposes a heavy financial burden on society at large. Patient-provider feedback loop with clinical support for SMBP monitoring. %%EOF However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. : 12-EHC002-EF. The .gov means its official. Take your blood pressure at the same time every day. 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. and transmitted securely. Your feet should be flat on the floor and your legs . 12-EHC002-EF. No studies of SMBP monitoring in children were identified. Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No. These types of minimally intensive approaches are important to test in all populations, especially those experiencing related health disparities, for broad implementation with . In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Updated Hypertension Guidelines: Implications for Treatment? This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. sharing sensitive information, make sure youre on a federal Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure 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. 45. Page originally created December 2020. 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]. How can I measure my blood pressure at home? To determine predictors of adherence with SMBP monitoring. May 28, 2010. Using SMBP to guide you in diagnosing and treating hypertension likely will produce better outcomes than using office blood pressure readings alone. 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. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness 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. Content last reviewed March 2021. Topline Findings: A National Analysis of Self-Measured Blood Pressure Monitoring Coverage and Reimbursement [PDF 1.7 MB] A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. Brown Affiliations Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. 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. 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. HHSA 290-2007-10055-I.) The cuff has a gauge on it that will measure your blood pressure. This website requires cookies, and the limited processing of your personal data in order to function. Untreated or ineffectively treated hypertension leads to increased cardiovascular . PDF Self-measured BP monitoring - American Medical Association Cite this: Self-Measured Blood Pressure Monitoring to Control Hypertension-Medscape-May06,2013.