8. Please enter a Recipient Address and/or check the Send me a copy checkbox. 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). MEDLINE, Cochrane Central Register of Controlled Trials, existing systematic and narrative reviews, recent conference proceedings, and the Food and Drug Administration. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. How to Use Your Home Blood Pressure Monitor FOIA 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. How does adherence with SMBP monitoring vary by patient factors? 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. 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. SMBP Health IT Checklist [PDF 136 KB] Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. The health care professional then inflates the cuff, which gently tightens on your arm. Measure Your Blood Pressure | cdc.gov This 2015 CPSTF systematic review evaluates the effectiveness of using SMBP with additional clinical support to manage high blood pressure and SMBP alone. 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). PDF Background Effective Health Care Program - Agency for Healthcare 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. 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. The direct and indirect cost of high BP and its complications has been estimated at more than $43.5 billion in 2007 in the U.S.7 Thus, it cannot be viewed simply as an individual health issue given the large public health impact and the potential for cost savings with effective prevention or treatment. Bookshelf Use this checklist: If you are keeping track of your blood pressure at home, use these additional tips. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure/research. The https:// ensures that you are connecting to the Rockville, MD: Agency for Healthcare Research and Quality. The Forum convenes online quarterly. 12-EHC002-EF. 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. 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. official website and that any information you provide is encrypted The review addressed SMBP monitoring performed by the patient or the patient's companion at home; it did not include monitoring done at the doctor's office, clinic, pharmacy, or health unit at work, nor did it include blood pressure (BP) monitoring done at home by nurses or other health care professionals. : 14-05198-EF-1. 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. Comparative Effectiveness Review Number 45 Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Executive Summary Background High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. To increase nationwide implementation of SMBP plus clinical support, multiple issues must be addressed. Telephone: (301) 427-1364, Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension, https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html, AHRQ Publishing and Communications Guidelines, Evidence-based Practice Center (EPC) Reports, Healthcare Cost and Utilization Project (HCUP), AHRQ Quality Indicator Tools for Data Analytics, United States Health Information Knowledgebase (USHIK), AHRQ Informed Consent & Authorization Toolkit for Minimal Risk Research, Grant Application, Review & Award Process, Study Sections for Scientific Peer Review, Getting Recognition for Your AHRQ-Funded Study, AHRQ Research Summit on Diagnostic Safety, AHRQ Research Summit on Learning Health Systems, National Action Alliance To Advance Patient Safety, Blood Pressure Control Evidence and Resources, Cholesterol Management Evidence and Resources, Advancing Heart Health Research and Results, U.S. Department of Health & Human Services. Many have undergone validation according to the recommendations of the American Association of Medical Instrumentation, the European Society of Hypertension or the British Hypertension Society.25,29 Generally, the use of validated devices is preferred. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. PMID: 23922064. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. Untreated or ineffectively treated hypertension leads to increased cardiovascular morbidity and mortality in individuals, increased consumption of health care resources, high financial and human costs to society. The primary objective of this review is to evaluate whether the use of SMBP monitoring influences outcomes in adults and children with hypertension and to what extent these changes in outcomes can be attributable to the use of self monitoring devices alone or the use of SMBP with additional support or attention provided. Rockville, MD 20857 government site. Take this form [PDF 105 KB]with you on your first blood pressure visit to record important blood pressure-related information. If you log out, you will be required to enter your username and password the next time you visit. Would you like email updates of new search results? 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. 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. Sit with your back straight and supported (on a dining chair, rather than a sofa). 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. Progestogens for Prevention of Preterm Birth. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. Many SMBP devices are commercially available. This program from the AMA and Johns Hopkins University School of Medicine is designed to help physician offices and health centers engage patients in SMBP monitoring. SMBP Coverage Insights: Medicaid [PDF 232 KB] How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States? One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. Purpose: 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. . John M. Eisenberg Center for Clinical Decisions and Communications Science. PDF Science-in-Brief Feature: Self-Measured Blood Pressure Monitoring - CDC SMBP = self-measured BP; KQ = Key Question The figure shows a schematic of possible comparisons between SMBP, SMBP plus additional, support without (more), In light of the potential health care benefits and knowledge gaps highlighted above, a topic titled Self Blood Pressure Monitoring was developed through the processes of topic identification, selection, and refinement for Comparative Effectiveness Review (CER) within the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care program.34. 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. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension. Please confirm that you would like to log out of Medscape. 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Self-Measured Blood Pressure Monitoring: Comparative Effectiveness U.S. Preventive Services Task Force (USPSTF) Final Recommendation Statement: Hypertension in Adults: Screening In: Daniel D, Prall M, editors. You can review and change the way we collect information below. This video from NACHC, showcases several community health centers work to implement SMBP monitoring programs in their clinics. Research Protocol . Very few trials evaluated objective clinical outcomes. 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 The HOME BP intervention for SMBP is an integrated patient-practitioner online digital tool. 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. Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video PDF CER 45 Self-Measured Blood Pressure Monitoring Comparative Federal government websites often end in .gov or .mil. 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.) Bethesda, MD 20894, Web Policies With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. (Comparative Effectiveness Reviews, No. For additional assistance, please contact us. Updated Hypertension Guidelines: Implications for Treatment? Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range.

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