Effectiveness of Home Blood Pressure Monitoring Among Low-Income Adults in Rural Appalachia

Abstract

Context: High blood pressure (BP) is a common chronic condition in the United States. For many people, BP control through pharmacologic intervention alone is not effective at maintaining a healthy BP. Team-based, patient-focused care and home-based BP monitoring in addition to pharmacologic interventions have been shown to be effective for controlling BP. Objective: To determine the effectiveness of the hypertension management program at the Heritage Community Clinic in Athens, Ohio. Methods: Medical records of 43 patients who took part in the hypertension management program were retrospectively reviewed and included clinical data such as age, sex, BP, body mass index, comorbidities, family history, and demographic information. In addition to standard pharmacologic interventions, the program provided equipment for at-home BP monitoring, education on behavior and lifestyle modification, and 5 follow-up visits. Data from the 5 follow-up visits were analyzed. Results: Linear mixed-effects regression models of BP suggested that the visit factor was significantly associated with BP (P<.001). On average at each visit, patients showed a 6.8–mm Hg reduction in systolic BP and a 3.8–mm Hg reduction in diastolic BP after controlling for demographic variables. General stress level, marital status, and depression were all significantly associated with BP (P<.05). In addition, 67.5% of the patients who took part in this program achieved the target treatment guidelines of the Eighth Joint National Committee for hypertension management. Conclusion: A clinic-based hypertension management program comprising patient education, support, medication, and home BP monitoring was effective at reducing BP.

Building Primary Care Research Capacity in a College of Osteopathic Medicine

“…10 A sample of OU-HCOM primary care researchers' work is included in this issue of The Journal of the American Osteopathic Association as part of The Journal's ENGAGE Initiative. 11 The researchers' work encompasses health care delivery, 12 students' attitudes toward practicing primary care, 13 a consortium-based research education continuum in osteopathic medicine, 14 and the benefits of being a patient. 15 The contribution to science as well as the enhancement of students' educational experience is paramount in our work.…”