SMBP monitoring is also commonly referred to as home blood pressure monitoring. Comparative Effectiveness Review No. No studies of SMBP monitoring in children were identified. y ^]J[_tFe^~4:;:Cxbh jXd%SElY*Oi1h{_DsnL Agency for Healthcare Research and Quality, Rockville, MD. FOIA Untreated or ineffectively treated hypertension leads to increased cardiovascular . PMC Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video 5600 Fishers Lane How to Use Your Home Blood Pressure Monitor 2012 Feb 15. To determine predictors of adherence with SMBP monitoring. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Dec. Report No. Progestogens for Prevention of Preterm Birth. : 13-05194-EF-1. 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 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. Allison is trained as an emergency medical technician and received a bachelor of science degree in biology and anthropology from the University of Michigan and a master of public health degree, with a focus in behavioral science and education, from Emory University. You will be subject to the destination website's privacy policy when you follow the link. 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). Repeated measurements are needed to facilitate accurate classification of patients. You will be subject to the destination website's privacy policy when you follow the link. 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 With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. 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. It has been the subject of a 2002 Evidence Practice Center (EPC) Evidence Report.25 A fuller description of ambulatory BP monitoring can be found there. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP 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. SMBP = self-measured BP; KQ = Key Question. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. Before Would you like email updates of new search results? hb```f`` & B,@Q+g~ Numerous health professional and government organizations have developed various guidelines for BP management. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. An official website of the Department of Health & Human Services. Neither is there consensus on how many serial measurements should be taken and which ones should be used or averaged to derive an accurate reading. The https:// ensures that you are connecting to the 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 health care professional then inflates the cuff, which gently tightens on your arm. SMBP Coverage Insights: Medicaid [PDF 232 KB] 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. First, a health care professional wraps an inflatable cuff around your arm. Take this form [PDF 105 KB]with you on your first blood pressure visit to record important blood pressure-related information. [3] (Figure 1). Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they dont use SMBP.3. Hypertension often requires lifelong treatment. Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. Rockville, MD 20857 Figure 1 shows possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. Bethesda, MD 20894, Web Policies The Evidence-based Practice Center (EPC) reviewed the existing body of evidence on the effects of SMBP on clinical, surrogate, and intermediate outcomes in the management of hypertension. endstream endobj startxref Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. Take at least two readings, 1 or 2 minutes apart. PMID: 23922064. Accessibility It predicted a rise by 24 percent in developed countries and 80 percent in developing countries by 2025.4 The World Health Report 2002 estimates that over 1 billion people have hypertension, which is estimated to cause 4.5 percent of the global disease burden.5 In addition, high BP directly results in 7 million deaths annually.6 Within the United States, about 76.4 million adults are affected.7 Data from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2008 indicated that 30 percent of all adults in the U.S. 18 years and older were hypertensive, with a higher prevalence among African Americans and the elderly.8 The prevalence of verified hypertension in children is more than 3 percent.2 A study from 2002 reported a lifetime risk of developing hypertension among adults aged 55 to 65 years in the U.S. as greater than 90 percent.9 Despite improvements in the quality of health care and life expectancy, it is expected that the prevalence of hypertension will continue to rise as the population ages. If you log out, you will be required to enter your username and password the next time you visit. 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. Addressing Barriers Beyond the Published Literature In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. 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. : 12-EHC002-EF. In: Daniel D, Prall M, editors. Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] This 2020 AMA handout for Current Procedural Terminology (CPT) provides codes and descriptions for SMBP-related services. 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. hbbd```b``A$ug`rX|" o/XDLHp0{W$5)"30^` w To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Million Hearts Science team, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GeorgiaDisclosure: Allison Goldstein, MPH, has disclosed no relevant financial relationships. How do health care professionals measure my blood pressure? Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. Taking Control of My Blood Pressure: DAngelos Story Read the full Million Hearts Hypertension Control Change Package. There are also a variety of kiosks available in stores and pharmacies. For additional assistance, please contact us. Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. 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. This one-page overview outlines the viability, costs, and returns for implementing an SMBP monitoring program based on Medicare reimbursement. One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers. Several national and international hypertension guidelines endorse self-measured BP monitoring. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. pharmacists and nurse practitioners) to manage patients' HBP (Figure 1). Source:Centers for Disease Control and Prevention. How can I measure my blood pressure at home? HHS Vulnerability Disclosure, Help sharing sensitive information, make sure youre on a federal They can help you make a plan to manage high blood pressure. 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. Please enable it to take advantage of the complete set of features! By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. 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, 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. Measure your blood pressure regularly to help your health care team diagnose any health problems early. %%EOF Content last reviewed March 2021. Rockville, MD: Agency for Healthcare Research and Quality. Cookies used to make website functionality more relevant to you. AHRQ Publication No. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. 5600 Fishers Lane 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. 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. 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. Purpose Take this form with you to your doctors office to record important blood pressure-related information. Register for the Million HeartsSMBP Forum, an opportunity for clinical, public health, and community-based partners to exchange best and promising practices, identify solutions to common obstacles, and share resources to accelerate SMBP monitoring uptake. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. >gL/?eEAV c,1t D~ 8-?x}0 KQUo~TJa&A6@sY(|x D G&pA32^Y|VLEcx 71HbFFhi3"9#+Z~GqESHm,Y-G1. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Aug. Report No. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. This video from NACHC features DAngelo, a patient who explains how he has taken control of his blood pressure with the help of SMBP monitoring. Data Sources: 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 Thank you. MEDLINE, Cochrane Central Register of Controlled Trials, existing systematic and narrative reviews, recent conference proceedings, and the Food and Drug Administration. Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. National Library of Medicine AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. A recent CDC study found that 67 million adult Americans have hypertension, and of those, 36 million are uncontrolled. This is an official U.S. government web site managed by the MeSH You will receive email when new content is published. Figure 1. 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. No studies evaluated children. Topline Findings: A National Analysis of Self-Measured Blood Pressure Monitoring Coverage and Reimbursement [PDF 1.7 MB] Background Hypertension often requires lifelong treatment. 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.) How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States? Purpose: in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence Rockville, MD 20857 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. Unauthorized use of these marks is strictly prohibited. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. They help us to know which pages are the most and least popular and see how visitors move around the site. and transmitted securely. Unauthorized use of these marks is strictly prohibited. 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.
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