The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. 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. ECG Challenge: What's Causing This Woman's Slow Pulse? pressure monitoring and refers to the regular use of a We also included longitudinal cohort studies in addressing adherence predictors. Balk, Ethan - Brown University Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video To determine predictors of adherence with SMBP monitoring. All information these cookies collect is aggregated and therefore anonymous. 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. This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure. Introduction. 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. Effective Health Care Program . 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. The Community Preventive Services Task Force (CPSTF) Recommendations on Self-Measured Blood Pressure Monitoring Interventions Measurements can be read by a person or provided digitally by a device. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. We standardized extraction by training on multiple articles, after which each study was extracted by one methodologist and the extraction reviewed by at least one other. To summarize evidence about the effectiveness of self-measured blood pressure (SMBP) monitoring in adults with hypertension. 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. These evidence-based action steps and resources, assembled by Million Hearts, can help practices implement SMBP monitoring. 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. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. Centers for Disease Control and Prevention. Take your blood pressure at the same time every day. 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. One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. Cookies used to make website functionality more relevant to you. This 2021 recommendation from the USPSTF includes additional guidance for obtaining blood pressure measurements away from the clinical setting. 2012 Feb 15. High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. This 2020 joint policy statement from the American Heart Association (AHA) and the AMA addresses barriers to implementing SMBP monitoring. This one-page overview outlines the viability, costs, and returns for implementing an SMBP monitoring program based on Medicare reimbursement. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. b W 35D43zi&J &lbP K 7X Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. %%EOF You can review and change the way we collect information below. SMBP plus clinical support can improve access to care and quality of care for people with hypertension while making blood pressure control more convenient and accessible across the population. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. PDF Coffee Break 2019: Effectiveness and Economic Evidence of Self-Measured Figure 2. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness PDF Self-Measured Blood Pressure Monitoring - Centers for Disease Control 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 Monitoring: Action Steps for Public Health Practitioners [PDF 1 MB] The site is secure. %PDF-1.6 % Use this checklist: If you are keeping track of your blood pressure at home, use these additional tips. 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? [3] (Figure 2). 45.) 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. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. While patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of SMBP remains uncertain. Bookshelf Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. A recent CDC study found that 67 million adult Americans have hypertension, and of those, 36 million are uncontrolled. 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. 2011 Aug 8. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. Taking Control of My Blood Pressure: Natalias Story Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. Rockville, MD 20857 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. Target: BP: Implement SMBP Choosing-a-Home-BP-Monitor At-a-Glance-Comparison [PDF 446 KB] There is no consensus on the precise protocol for SMBP monitoring in the management of hypertension regarding timing, frequency and duration. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. National Library of Medicine Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. Careers. There is insufficient evidence concerning predictors of SMBP adherence. Self-Measured Blood Pressure: Future Research Needs: Identification of 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. Disclaimer. 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. 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. PMID: 23922064. 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Hello. 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 clinic26, SMBP is being used to avoid undertreatment of hypertension. HHS Vulnerability Disclosure, Help Addressing Barriers Beyond the Published Literature Patient-provider feedback loop with clinical support for SMBP monitoring. Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. Federal government websites often end in .gov or .mil. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Content last reviewed March 2021. Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Accessibility Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP CDCs 6|18 Initiative: Accelerating Evidence into Action They help us to know which pages are the most and least popular and see how visitors move around the site. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. 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"" Self-Measured Blood Pressure Monitoring: Comparative Effectiveness This 2012 AHRQ review examined the comparative effectiveness of SMBP alone, of SMBP plus additional clinical support, and of usual care. Why do I need to measure my blood pressure? All information these cookies collect is aggregated and therefore anonymous. 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. 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). SMBP Coverage Insights: Medicaid [PDF 232 KB] 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. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Impact of SelfMonitoring of Blood Pressure on Processes of 5600 Fishers Lane 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. Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. 2012 Mar 19. The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. 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. 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. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Self-Measured Blood Pressure Monitoring . All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. 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. Data extraction Data on . Uhlig K, Balk EM, Patel K, Ip S, Kitsios GD, Obadan NO, et al. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. Self-Measured Blood Pressure Monitoring | Million Hearts Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. 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). Current settings for BP measurement include BP measurement in a healthcare setting, or BP measurement in a patient's usual environment with either ambulatory BP monitoring, or self-measured BP (SMBP) monitoring. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. This process is quick and painless. What you need to know about self-measured blood pressure monitoring Reliable clinic measurements require an adequate rest period prior to measurement in order to enhance the consistency of BP readings. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. However, even when measured according to established guidelines, clinic BP measurements have several limitations. Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians [PDF 947 KB] This AMAAHA joint initiative can help health care professionals launch an SMBP monitoring program. 2012 Sep 21. No studies evaluated children. Other factors that can improve accuracy include the use of an appropriately sized cuff and slow cuff deflation. Please enable it to take advantage of the complete set of features! 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 Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. Clinical support includes regular one-on-one counseling, web-based or telephonic support tools, and educational classes. Clipboard, Search History, and several other advanced features are temporarily unavailable. Many studies were of moderate to poor quality and had short followup periods. 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). 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. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No.
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