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Heart Disease and Stroke Prevention: Self-Measured Blood Pressure Monitoring Interventions for Improved Blood Pressure Control When Combined with Additional Support

NewCDC

An Evidence-Based Practice

Description

Self-measured blood pressure monitoring interventions support and promote the use of personal blood pressure measurement devices in the management and treatment of high blood pressure. Patients are trained to use validated, and usually automated, blood pressure measurement devices on a regular basis in familiar settings, typically their homes. Patients share blood pressure readings with their healthcare providers during clinic visits, by telephone, or electronically. These measurements are monitored and used in treatment decisions to improve blood pressure control.

Self-measured blood pressure monitoring interventions combined with additional support include one or more of the following:
-One-on-one patient counseling on medications and health behavior changes (e.g., diet and exercise)
-Educational sessions on high blood pressure and blood pressure self-management
-Access to electronic or web-based tools (e.g., electronic requests for medication refills, text or email reminders to measure blood pressure or attend appointments, direct communications with healthcare providers via secure messaging)

Self-measured blood pressure monitoring interventions are often used with team-based care.

Impact

The Community Preventive Services Task Force (CPSTF) recommends self-measured blood pressure monitoring interventions combined with additional support to improve blood pressure outcomes in patients with high blood pressure. Additional support may include patient counseling, education, or web-based support. Economic evidence indicates that self-measured blood pressure monitoring interventions are cost-effective when they are used with additional support or within team-based care.

Results / Accomplishments

The systematic review included 25 studies with 29 study arms.

Blood Pressure Outcomes
-Proportion of patients with blood pressure at goal: median increase of 5.3 percentage points (median duration: 9 months; 18 study arms)
-Change in mean systolic blood pressure: median reduction of 4.6 mmHg (median duration: 12 months; 26 study arms)
-Change in diastolic blood pressure: median reduction of 2.3 mmHg (median duration: 9 months; 28 study arms)
-Results demonstrated consistent and meaningful improvements in blood pressure that were sustained at 12 months when compared with usual care.

Other Outcomes
-One study conducted over a five year period reported lower death rates among patients receiving self-measured blood pressure monitoring combined with educational sessions compared with patients receiving usual care.
-Findings were inconsistent for outcomes measuring medication adherence, health-related quality-of-life, or patient satisfaction.

About this Promising Practice

Primary Contact
The Community Guide
1600 Clifton Rd, NE
MS H21-8
Atlanta, GA 30329
(404) 498-1827
communityguide@cdc.gov
https://www.thecommunityguide.org/
Topics
Health / Heart Disease & Stroke
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Prince George's County Health Department