RT Journal Article
SR Electronic
T1 Success in the Achieving CARdiovascular Excellence in Colorado (A CARE) Home Blood Pressure Monitoring Program: A Report from the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 548
OP 555
DO 10.3122/jabfm.2015.05.150024
VO 28
IS 5
A1 DeAlleaume, Lauren
A1 Parnes, Bennett
A1 Zittleman, Linda
A1 Sutter, Christin
A1 Chavez, Robert
A1 Bernstein, Jackie
A1 LeBlanc, William
A1 Dickinson, Miriam
A1 Westfall, John M.
YR 2015
UL http://www.jabfm.org/content/28/5/548.abstract
AB Background: Blood pressure (BP) control among primary care patients with hypertension is suboptimal. Home BP monitoring (HBPM) has been shown to be effective but is underused.Methods: This study was a quasi-experimental evaluation of the impact of the A CARE HBPM program on hypertension control. Nonpregnant adults with hypertension or cardiovascular disease risk factors were given validated home BP monitors and reported monthly average home BP readings by Internet or phone. Patients and providers received feedback. Change in average home and office BP and the percentage of patients achieving target BP were assessed based on patient HBPM reports and a chart audit of office BPs.Results: A total of 3578 patients were enrolled at 26 urban and rural primary care practices. Of these, 36% of participants submitted ≥2 HBPM reports. These active participants submitted a mean of 13.5 average HBPM reports, with a mean of 19.3 BP readings per report. The mean difference in home BP between initial and final HBPM reports for active participants was −6.5/−4.4 mmHg (P < .001) and −6.7/−4.7 mmHg (P < .001) for those with diabetes. The percentage of active participants at or below target BP increased from 34.5% to 53.3% (P < .001) and increased 24.6% to 40.0% (P < .001) for those with diabetes. The mean difference in office BP over 1 year between participants and nonparticipants was −5.4/−2.7 mmHg (P < .001 for systolic BP, P = .01 for diastolic BP) for all participants and −8.5/−1.5 mmHg (P = .014 for systolic BP, P = .405 for diastolic BP) for those with diabetes.Conclusions: An HBPM program with patient and provider feedback can be successfully implemented in a range of primary care practices and can play a significant role in BP control and decreased cardiovascular disease risk in patients with hypertension.