Prevalence and factors affecting home blood pressure documentation in routine clinical care: a retrospective study

Kramer, Michael H.; Breydo, Eugene; Shubina, Maria; Babcock, Kelly; Einbinder, Jonathan S.; Turchin, Alexander

doi:10.1186/1472-6963-10-139

Cited by 10 publications

(5 citation statements)

References 33 publications

(30 reference statements)

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“…Previous studies among general patients with hypertension (primary care or community settings) have shown inconsistent results. Some studies reported that patients with a higher education level, higher income, male sex and a younger age were more likely to adopt HBPM [2,13,21,22], while other studies found higher HBPM use in older adults [14,22,23]. In this study, sex negatively affected adoption of HBPM, and older patients were more likely to use HBPM.…”

Section: Resultscontrasting

confidence: 48%

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension

Zuo

Wang

et al. 2020

Preprint

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Background: Home blood pressure monitoring (HBPM) is recommended and specified for diagnosis, treatment adjustment and management of most hypertension cases by hypertension guidelines. This study aimed to evaluate the HBPM behaviour and to explore the routine-practice gap among Chinese adults with hypertension. Methods: Between October 2014 and November 2014, data were collected from 20 communities across three cities and six townships in three provinces located in Beijing, Shandong and Jiangsu Provinces in China. A total of 2,272 patients with hypertension aged ≥35 years were registered with a primary health station in local communities were selected by simple random sampling. Results: Among 2,272 subjects, 45.3% owned a home sphygmomanometer. In addition, 27.5% (625/2,272) engaged in HBPM weekly or more frequently. Healthcare providers’ advice was the strongest factor contributing to home sphygmomanometer ownership and weekly HBPM behaviour, with an odds ratio of 13.50 and 8.97. Patients with uncontrolled hypertension were more likely to conduct HBPM regularly (morning and evening), measure their BP two or three times in each measuring session and report 7 consecutive days of HBPM than patients with controlled hypertension (8.8% vs. 5.8%, P=0.042; 14.3% vs. 8.1%, P=0.002; and 19.9% vs. 12.4%, P=0.005, respectively). Only 16.0% (165/1,030) of patients actively reported their HBPM readings to doctors. Conclusion: The strategies of HBPM specified by ESH/ESC hypertension guidelines (2013) and those from China (2018) are seldom achieved in current practice in China. Only a small proportion of patients actively participate in utilizing home BP measurements to enhance their care. HBPM may be improved by healthcare providers’ specific advice and training.

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Section: Resultscontrasting

confidence: 48%

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension

Zuo

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Previous studies among general patients with hypertension (primary care or community settings) have shown inconsistent results. Some studies reported that patients with a higher education level, higher income, male sex and a younger age were more likely to adopt HBPM [2,15,22,23], whereas other studies found higher HBPM use in older adults [16,23,24]. In this study, no difference in HBPM was found between males and females, and older participants were more likely to use HBPM.…”

Section: Discussioncontrasting

confidence: 74%

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension

Zuo

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Home blood pressure monitoring (HBPM) is recommended for diagnosis, treatment adjustment and management of most hypertension cases in hypertension guidelines from multiple countries. This study aimed to evaluate HBPM behaviour and explore the routine-practice gap in HBPM among Chinese adults with hypertension. Methods: Data were collected from 20 communities across three cities and six townships in three provinces (Beijing, Shandong and Jiangsu) in China between October 2014 and November 2014. In total, 2,272 patients with hypertension aged ≥35 years that were registered with a primary health station in their local communities were selected by simple random sampling. Results: Among the 2,272 participants, 45.3% owned a home blood pressure (BP) monitor. In addition, 27.5% (625/2,272) engaged in HBPM weekly or more frequently. Healthcare providers’ advice was the strongest factor contributing to home BP monitor ownership and weekly HBPM behaviour, with odds ratios of 13.50 and 8.97, respectively. Approximately 4.4% of participants had achieved optimal HBPM regimens (duplicate measurements in the morning and evening for 7 days). Patients with uncontrolled office-measured BP were more likely to conduct HBPM regularly in the morning and evening, measure their BP two or three times in each session and maintain 7 consecutive days of HBPM than patients with controlled office BP (8.8% vs. 5.8%, P=0.042; 14.3% vs. 8.1%, P=0.002; and 19.9% vs. 12.4%, P=0.005, respectively). Only 16.0% (165/1,030) of participants actively reported their HBPM readings to doctors. Conclusion: The HBPM strategies specified in hypertension guidelines are seldom achieved in actual practice in China. Only a small proportion of patients actively participate in using HBPM to enhance their hypertension care. HBPM may be improved by healthcare providers offering specific advice and training.

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“…This is consistent with prior investigations that showed that a large fraction of medical information is recorded only in narrative (e.g. provider notes) but not structured data [35,36,37]. While manual chart review of large numbers of records to abstract information from narrative documents is not always feasible, natural language processing technology can allow for rapid and accurate identification of critical pieces of information [38].…”

Section: Discussionsupporting

confidence: 71%

Reasons for Discontinuation of Lipid-Lowering Medications in Patients with Chronic Kidney Disease

et al. 2014

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Background/Aims: Many patients with chronic kidney disease (CKD) do not receive lipid-lowering therapy despite their high cardiovascular risk. The reasons for this are unknown. Methods: We have conducted a retrospective cohort study of discontinuation of lipid-lowering drugs in patients with CKD stage 3 and higher treated in practices affiliated with two academic medical centers between 2000 and 2010. Information on medication discontinuation and its reasons was obtained from electronic medical records, including natural language processing of electronic notes using previously validated software. Results: Out of 14,034 patients in the study cohort, 10,072 (71.8%) stopped their lipid-lowering drugs at least once, and 2,444 (17.4%) stopped them for at least 1 month. Patients who had a comorbidity associated with higher cardiovascular risk were less likely to stop lipid-lowering drugs. Insurance request was the most common explicitly documented reason for discontinuation, and adverse reactions were the most common reason for long-term discontinuation. In a multivariable analysis, patients were more likely to stop a lipid-lowering drug because of an insurance request if they had government insurance and they were also more likely to stop a lipid-lowering drug because of adverse reactions if they had a history of multiple adverse reactions to other medications. There was no significant relationship between CKD stage and the reason for discontinuation of lipid-lowering drugs. Conclusions: Patients with CKD frequently stop lipid-lowering drugs. Insurance requests and adverse reactions are common reasons for the discontinuation. Further research is needed to ensure appropriate lipid-lowering therapy for these individuals at high cardiovascular risk. i 2014 S. Karger AG, Basel

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Prevalence and factors affecting home blood pressure documentation in routine clinical care: a retrospective study

Cited by 10 publications

References 33 publications

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension

Reasons for Discontinuation of Lipid-Lowering Medications in Patients with Chronic Kidney Disease

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