Unreliability of Home Blood Pressure Measurement and the Effect of a Patient-Oriented Intervention

Milot, Jean-Philippe; Birnbaum, Leora; Larochelle, Pierre; Wistaff, Robert; Laskine, Mikhael; Nguyen, P.; Lamarre-Cliché, Maxime

doi:10.1016/j.cjca.2015.03.006

Cited by 42 publications

(34 citation statements)

References 21 publications

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“…Recent studies indicate that only 10% to 17% of clinicians provide HBPM training that is even minimally adherent to guidelines for accurate measurement, [22][23][24] and fewer than 20% of patients may be sufficiently adherent to the recommended HBPM technique to ensure reliable HBPM. 14,25,26 Compared with ABPM, HBPM requires a substantial commitment to training by both clinics and patients, and it may require individual, face-to-face instruction for optimal results. 13,14,26 Our assessment of Utah primary care clinics found similar concerns about their current delivery of patient training to facilitate accurate HBPM.…”

Section: Discussionmentioning

confidence: 99%

“…14,25,26 Compared with ABPM, HBPM requires a substantial commitment to training by both clinics and patients, and it may require individual, face-to-face instruction for optimal results. 13,14,26 Our assessment of Utah primary care clinics found similar concerns about their current delivery of patient training to facilitate accurate HBPM. Only 27.6% had a written policy for training patients in HBPM, 36.6% distributed written HBPM instructional materials, and just 48.8% had designated a team member to provide individual HBPM instruction.…”

Section: Discussionmentioning

confidence: 99%

“…6 -10 Are primary care clinics adequately prepared to implement these recommendations for accurate OBPM and out-of-office BP monitoring for the 70 million patients with hypertension in the United States? 11 Effective implementation of these interventions requires the use of OBPM and HBPM devices validated for accuracy by international protocols, 12 training and subsequent monitoring of both clinic staff and patients in correct OBPM and HBPM protocols, 13,14 convenient access to 24-hour ABPM services, 15,16 and, optimally, use of an electronic health record (EHR) or electronic registry that can identify and track hypertension patients and their HBPM values. 17 Utah formed the Utah Million Hearts Coalition (UMHC) as part of the national Million Hearts initiative to prevent 1 million heart attacks and strokes by 2017.…”

mentioning

confidence: 99%

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Diagnosing Hypertension in Primary Care Clinics According to Current Guidelines

et al. 2017

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Purpose: This descriptive study examines hypertension diagnostic practices in Utah primary care clinics relative to the 2015 US Preventive Services Task Force (USPSTF) recommendations for the accurate diagnosis of hypertension. We assessed clinic procedures in place to facilitate accurate in-office and outof-office blood pressure (BP) measurement.Methods: An online questionnaire was administered to 321 primary care clinics. We compared current clinic BP measurement practices with the USPTF recommendations and assessed the level of adherence to the recommendations by level of clinic integration with a hospital.Results: Of the 321 primary care clinics that received the assessment, 123 (38.3%) completed the questionnaire. Clinics varied significantly in their ability to provide accurate in-office measurement, ranging from 57.5% to 93.5% of clinics complying with USPSTF recommendations. Only 25.2% of clinics reported having access to ambulatory monitoring and 36.6% had instructional materials for accurate home BP monitoring. Clinics integrated with a hospital were more likely to report adherence to recommendations than solo or independent clinics (36.4% vs 10.5%; P < .01).Conclusion :

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnosing Hypertension in Primary Care Clinics According to Current Guidelines

et al. 2017

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“…BP measurements over thick clothing were found to be less accurate than measurements on bare arms 4. However, measuring BP according to the guidelines is difficult in the office,5 at home,6 and in inpatient settings 7…”

Section: Introductionmentioning

confidence: 99%

Adherence to blood pressure measurement guidelines in long‐term care facilities: A cross sectional study

Ozone

Takayashiki

Sakamoto

et al. 2018

J of Gen and Family Med

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ObjectiveTo assess the extent to which long‐term care facilities in Japan adhere to blood pressure (BP) measurement guidelines.DesignCross‐sectional, observational survey.SettingJapan (nationwide).ParticipantsGeriatric health service facilities that responded to a questionnaire among 701 facilities that provide short‐time daycare rehabilitation services in Japan.MethodsA written questionnaire that asked about types of measurement devices, number of measurements used to obtain an average BP, resting time prior to measurement, and measurement methods when patients’ arms were covered with thin (eg, a light shirt) or thick sleeves (eg, a sweater) was administered.Main outcome measureProportion of geriatric health service facilities adherent to BP measurement guidelines.ResultsThe response rate was 63.2% (443/701). Appropriate upper‐arm BP measurement devices were used at 302 facilities (68.2%). The number of measurements was appropriate at 7 facilities (1.6%). Pre‐measurement resting time was appropriate (≥5 minutes) at 205 facilities (46.3%). Of the 302 facilities that used appropriate BP measurement devices, 4 (1.3%) measured BP on a bare arm if it was covered with a thin sleeve, while 266 (88.1%) measured BP over a thin sleeve. When arms were covered with thick sleeves, BP was measured on a bare arm at 127 facilities (42.1%) and over a sleeve at 78 facilities (25.8%).Conclusions BP measurement guidelines were not necessarily followed by long‐term care service facilities in Japan. Modification of guidelines regarding removing thick sweaters and assessing BP on a visit‐to‐visit basis might be needed.

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“…This phenomenon was also observed in studies with conventional BP monitors, which reported that 52-65% patients missed at least one step of a correct BP measurement. [36,37] Milot et al found that only 18% of the patients performed the classic BP measurement with cuff excellent, [38] and a study of Wagner et al found that none of the participants performed BP measurement completely correct. [39] Compared with these observations in classical cuff based BP measurement, the correct use of the Checkme in our study was much better.…”

Section: Patient Experiencementioning

confidence: 99%