If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. SMBP means you regularly use a personal blood pressure measurement device away from a doctor's office or hospitalusually at home. An official website of the Department of Health & Human Services. 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. PDF Self-Measured Blood Pressure Monitoring - Centers for Disease Control Bethesda, MD 20894, Web Policies HHS Vulnerability Disclosure, Help Several national and international hypertension guidelines endorse self-measured BP monitoring. Clipboard, Search History, and several other advanced features are temporarily unavailable. There are two BP monitoring strategies that can currently be used at home: Ambulatory and SMBP monitoring. 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. Page originally created December 2020. While patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of SMBP remains uncertain. PMC 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. This process is quick and painless. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Patients may require some instruction on how to use SMBP devices.30,31. Strategies aimed at the control of high BP as well as adherence to medication continue to be of foremost concern to providers and patients, health care payers, policymakers, and governments worldwide. 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Data Extraction: SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. 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. National Library of Medicine Self Measured Blood Pressure Monitoring (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control. Internet Citation: Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. How can I measure my blood pressure at home? 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]. Self-Measured Blood Pressure Monitoring Definition and Indications SMBP plus additional clinical support is one alternative to traditional oce care that could improve access to care and quality of care for individuals with hypertension while making blood pressure control more convenient and accessible across the population. Centers for Disease Control and Prevention. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. Associate Director, Center for Health Services Research in Primary Care Durham Veterans Affairs Medical Center Numerous health professional and government organizations have developed various guidelines for BP management. 5600 Fishers Lane Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video Self-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Learn the correct way to have your blood pressure taken, whether youre getting it checked at the doctors office or checking it yourself at home. How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States? How do different devices for SMBP monitoring compare with each other (specifically semiautomatic or automatic versus manual) in their effects on clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence)? Using SMBP to guide you in diagnosing and treating hypertension likely will produce better outcomes than using office blood pressure readings alone. 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. Rockville, MD 20857 Internet Citation: There are also a variety of kiosks available in stores and pharmacies. 45. 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). Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. . 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. Purpose 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. MEDLINE, Cochrane Central Register of Controlled Trials, existing systematic and narrative reviews, recent conference proceedings, and the Food and Drug Administration. Self-Measured Blood Pressure: Future Research Needs: Identification of Methods - Self-Measured Blood Pressure Monitoring: Comparative Self-Measured Blood Pressure Monitoring | Million Hearts You and your health care team can take steps to control your blood pressureif it is too high. 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. Piper MA, Evans CV, Burda BU, Margolis KL, OConnor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP. Hypertension also imposes a heavy financial burden on society at large. 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. These blood pressure monitors are easy and safe to use. You will receive email when new content is published. The site is secure. Empty your bladder and ensure at least 5 minutes of quiet rest before measurements. First, a health care professional wraps an inflatable cuff around your arm. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. 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. PMC HHSA 290-2007-10055-I.) Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. 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. 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 clinic 26 Study Selection: b W 35D43zi&J &lbP K 7X As self-measurement requires patient participation, certain patient characteristics may affect compliance with SMBP monitoring, such as the willingness and ability to self-monitor BP and the technical literacy in operating the device or an interface for telemonitoring. Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. Technically, SMBP monitoring refers to regular measurement by the patient of his or her own BP. The https:// ensures that you are connecting to the Very few trials evaluated objective clinical outcomes. You will be subject to the destination website's privacy policy when you follow the link. Target: BP: Implement SMBP i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i 0 343 0 obj <>stream SMBP Health IT Checklist [PDF 136 KB] How to Measure Your Blood Pressure at Home [PDF 255 KB] PDF CER 45 Self-Measured Blood Pressure Monitoring Comparative If you have high blood pressure, talk to your health care team about steps to take to control your blood pressureto lower your risk for heart disease and stroke. Apr 11, 2011. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. 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. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. Updated Hypertension Guidelines: Implications for 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. J Athl Train. 12-EHC002-EF. Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure official website and that any information you provide is encrypted Self-Measured Blood Pressure Monitoring - Medscape See the resources below for specific recommendations. SMBP = self-measured BP; KQ = Key Question. Background: Introduction. Agency for Healthcare Research and Quality (AHRQ) Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [PDF 1.2 MB] 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? Rockville, MD 20857 Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Please enable it to take advantage of the complete set of features! How does adherence with SMBP monitoring vary by patient factors? The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. 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. : 14-05204-EF-1. https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html. Obtaining Adequate Fixation in a Periprosthetic Humerus Fracture Around a Shoulder Arthroplasty Stem in 81-Year-Old Man, ECG Challenge: Irregular Pulse During Cardiology Visit. This 2020 joint policy statement from the American Heart Association (AHA) and the AMA addresses barriers to implementing SMBP monitoring. Content last reviewed August 2018. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness 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. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. This document provides action steps for public health practitioners to facilitate the implementation of SMBP monitoring plus additional support in five key areas: Understanding the environment; Working with payers and purchasers; Working with health care providers; Spreading the word to the public; and Monitoring/assessment of SMBP, plus additional support implementation. 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. 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 https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure. Share this graphic with family and friends to show them the correct way to measure blood pressure. Self-Measured Blood Pressure Monitoring . Brown Affiliations SMBP plus clinical support interventions should be delivered by a trained healthcare provider, such as a pharmacist or nurse, and include regular communication of patient SMBP readings to providers and a patient-provider feedback loop. sharing sensitive information, make sure youre on a federal To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. How to Use Your Home Blood Pressure Monitor Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. The Forum convenes online quarterly. 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. PDF Background Effective Health Care Program - Agency for Healthcare Taking Control of My Blood Pressure: DAngelos Story This resource from the Public Health Informatics Institute provides a checklist of helpful characteristics for SMBP telemonitoring software. 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. sharing sensitive information, make sure youre on a federal To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National . Impact of SelfMonitoring of Blood Pressure on Processes of Is immediate imaging important in managing low back pain? This article outlines high-level SMBP barriers that federal/national partners have encountered and offers potential solutions to achieve widespread SMBP implementation. Hypertension Medication for Specific Comorbidities, Individualized Weight Monitoring Using the Heartphone, Home Blood Pressure Monitoring in Patients With Hypertension. 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. This includes encouraging the purchase of fully automated, validated home blood pressure monitors with a properly sized arm cuff, training patients in SMBP techniques, checking patients' measurement techniques for accuracy, and interpreting and providing counseling based on shared blood pressure readings. With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. In addition, SMBP may carry the risk of unreliable BP readings if not obtained in a standard fashion, inappropriate self adjustments of antihypertensive medications, as well as increased anxiety in susceptible patients. May 28, 2010. You've successfully added to your alerts. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. To sign up for updates or to access your subscriberpreferences, please enter your email address below. For all comparisons, evidence for clinical outcomes was insufficient; for all other outcomes (surrogate and intermediate outcomes, and health care encounters) strength of evidence was low, thus failing to support a difference. Background Hypertension often requires lifelong treatment. Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Measurements can be read by a person or provided digitally by a device. Regular BP measurement by visiting nurses or other health care professionals at home is not considered to be SMBP monitoring. 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. Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP 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. Comparative Effectiveness Review No. A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was . This 2012 AHRQ review examined the comparative effectiveness of SMBP alone, of SMBP plus additional clinical support, and of usual care. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence predictors of SMBP monitoring. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. [3] (Figure 2). They help us to know which pages are the most and least popular and see how visitors move around the site. Measure your blood pressure regularly to help your health care team diagnose any health problems early. An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring SMBP differs from clinic-based and ambulatory blood . This list of resources from the Million Hearts Hypertension Control Change Package can help assign care team roles for an SMBP monitoring program and guide patients on selecting a home blood pressure monitor. PDF Science-in-Brief Feature: Self-Measured Blood Pressure Monitoring - CDC Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. [3] (Figure 1). A recent CDC study found that 67 million adult Americans have hypertension, and of those, 36 million are uncontrolled. The Correct Way to Measure Blood Pressure Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO. Centers for Disease Control and Prevention. 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. 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 John M Eisenberg Center for Clinical Decisions and Communications Science. sX Ndb`T~ Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. This patient-friendly video from the Release the Pressure Coalition highlights the key steps people can take for accurate SMBP monitoring. A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. 2011 Aug 8. How often should I measure my blood pressure? If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. You can review and change the way we collect information below. is a member of the Million Hearts Science team with the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention. Finally, SMBP may be useful in preventing overtreatment in individuals with white coat syndrome, orthostatic BP changes, or hypotensive episodes from medication. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Aug. Report No. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. Measurements may interfere with a patient's activity or sleep. Many studies were of moderate to poor quality and had short followup periods. Archived: This report is greater than 3 years old. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. Would you like email updates of new search results? Ann Intern Med. 8. Accessibility dabl Educational Trust: Sphygmomanometers for Self-measurement of Blood Pressure, British Hypertension Society: Blood Pressure Monitors Validated for Home Use, AHRQ Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. We included studies that used arm (not wrist) monitors for at least 8 weeks and excluded studies of pregnant women or people on hemodialysis. 45.) Research Protocol . 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. Unable to load your collection due to an error, Unable to load your delegates due to an error, Self-Measured Blood Pressure Monitoring: Comparative Effectiveness [Internet]. Bookshelf Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? An official website of the United States government. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. Agency for Healthcare Research and Quality (US), Rockville (MD). Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Data extraction Data on . 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).

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