Introduction. 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. Centers for Disease Control and Prevention. Take your blood pressure at the same time every day. HHS Vulnerability Disclosure, Help Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO. Data Extraction: 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. Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. Choosing-a-Home-BP-Monitor At-a-Glance-Comparison [PDF 446 KB] 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)? You and your health care team can take steps to control your blood pressureif it is too high. Click the topic below to receive emails when new articles are available. If you are concerned about your blood pressure numbers, talk to your health care team. Rockville, MD 20857 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. Unauthorized use of these marks is strictly prohibited. Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. Ambulatory BP monitoring requires a technologist to program the machine, fit it on the patient, remove it and download the results and a physician to interpret them. To determine predictors of adherence with SMBP monitoring. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. There is insufficient evidence concerning predictors of SMBP adherence. SMBP Health IT Checklist [PDF 136 KB] This video from NACHC, showcases several community health centers work to implement SMBP monitoring programs in their clinics. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Source:Centers for Disease Control and Prevention. An official website of the Department of Health & Human Services. This one-page overview outlines the viability, costs, and returns for implementing an SMBP monitoring program based on Medicare reimbursement. 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. Accessibility An official website of the United States government. 2011 Aug 8. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 343 0 obj <>stream All information these cookies collect is aggregated and therefore anonymous. 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. Piper MA, Evans CV, Burda BU, Margolis KL, OConnor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. Addressing Barriers Beyond the Published Literature, Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association, An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring, Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness, U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening, Division for Heart Disease and Stroke Prevention, Live to the Beat Campaign Partner Toolkit. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure/research. To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National . 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"" 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. 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. 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 All information these cookies collect is aggregated and therefore anonymous. Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. 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). Bookshelf Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association SMBP monitoring is also commonly referred to as home blood pressure monitoring. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. 45. 45. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. 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. No studies of SMBP monitoring in children were identified. This site provides a list of clinically validated blood pressure devices, based on the American Medical Associations (AMA) established criteria to independently validate clinical accuracy. 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. 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. CDC twenty four seven. Progestogens for Prevention of Preterm Birth. 0 Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy [PDF 441 KB] This patient-friendly video from the Release the Pressure Coalition highlights the key steps people can take for accurate SMBP monitoring. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. 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. 315 0 obj <>/Filter/FlateDecode/ID[]/Index[293 51]/Info 292 0 R/Length 113/Prev 421311/Root 294 0 R/Size 344/Type/XRef/W[1 3 1]>>stream There is within-individual biological variability as well as measurement error. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. Measurements may interfere with a patient's activity or sleep. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension 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. 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]. Before MEDLINE, Cochrane Central Register of Controlled Trials, existing systematic and narrative reviews, recent conference proceedings, and the Food and Drug Administration. 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. This site needs JavaScript to work properly. These evidence-based action steps and resources, assembled by Million Hearts, can help practices implement SMBP monitoring. Data Sources: The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. 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. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. A BP cuff is placed around the upper arm and left in place for approximately 24 hours. These blood pressure monitors are easy and safe to use. These cookies may also be used for advertising purposes by these third parties. FOIA To sign up for updates or to access your subscriberpreferences, please enter your contact information below. In otherwise healthy adults, hypertension is defined as a persistently elevated BP equal to or greater than 140/90 mmHg.1 The recommended BP measurement technique is to average two readings taken in a person after 5 minutes quietly seated in chair.1 In children, the diagnosis is made from an average of three or more BP readings greater than the 95th percentile for age, sex, and height.2,3 The Seventh Joint National Committee (JNC 7) guideline recommends a BP goal of 140/90 mmHg or less in the general population and a lower goal of 130/80 mmHg or less in patients with diabetes mellitus or chronic kidney disease.1. National Library of Medicine The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Content last reviewed August 2018. Your feet should be flat on the floor and your legs . Findings may be used for research purposes, but should not be considered current. A recent CDC study found that 67 million adult Americans have hypertension, and of those, 36 million are uncontrolled. If you log out, you will be required to enter your username and password the next time you visit. PMC i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i How to Measure Your Blood Pressure at Home [PDF 255 KB] 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. Support interventions can be delivered outside of a normal office visit -- for example via telephone, email, or Internet portal -- thereby reducing the necessary frequency of face-to-face visits. 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. Other factors that can improve accuracy include the use of an appropriately sized cuff and slow cuff deflation. government site. Hypertension also imposes a heavy financial burden on society at large. The https:// ensures that you are connecting to the 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. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. : 14-05198-EF-1. Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Addressing Barriers Beyond the Published Literature Readings by a person can be affected by observer training, preference, and bias. SMBP CPT Coding [PDF 1 MB] The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. In that role, she provides scientific expertise to support research translation related to Million Hearts priority strategies. SMBP = self-measured BP; KQ = Key Question. Page originally created December 2020. There is insufficient evidence concerning predictors of SMBP adherence. 45. The Correct Way to Measure Blood Pressure Clinical support includes regular one-on-one counseling, web-based or telephonic support tools, and educational classes. 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)? Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. J Athl Train. The site is secure. With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. The health care professional then inflates the cuff, which gently tightens on your arm. 8600 Rockville Pike Many studies were of moderate to poor quality and had short followup periods. Uhlig K, Balk EM, Patel K, et al. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. 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. 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. In: Daniel D, Prall M, editors. 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. Background Hypertension often requires lifelong treatment. Self-Measured Blood Pressure Monitoring . 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. 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 Empty your bladder and ensure at least 5 minutes of quiet rest before measurements. Blood Pressure Validated Device Listing (VDL), Self-Measurement: How Patients and Care Teams Are Bringing Blood Pressure to Control, An Economic Case for Self-Measured Blood Pressure (SMBP) Monitoring [PDF - 156 KB], Choosing-a-Home-BP-Monitor At-a-Glance-Comparison, Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis, Tools to Establish a Self-Measured BP (SMBP) Monitoring Program, Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement, Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy, Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure, Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians, Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring, Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP) Through Clinical-Community Care Models, Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners, Topline Findings: A National Analysis of Self-Measured Blood Pressure Monitoring Coverage and Reimbursement, CDCs 6|18 Initiative: Accelerating Evidence into Action, Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video, How to Use Your Home Blood Pressure Monitor, Taking Control of My Blood Pressure: DAngelos Story, Taking Control of My Blood Pressure: Natalias Story, How to Measure Your Blood Pressure at Home, The Correct Way to Measure Blood Pressure, How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States?
