Unreliability of home blood pressure measurement and the effect of a patient-oriented intervention

Can J Cardiol. 2015 May;31(5):658-63. doi: 10.1016/j.cjca.2015.03.006. Epub 2015 Mar 11.

Abstract

Background: Home blood pressure (BP) measurement (HBPM) is recommended for the diagnosis and follow-up of high BP. It is unclear how this aspect of BP monitoring has evolved over the years and whether interventions could influence patient adherence to HBPM guidelines.

Methods: After a questionnaire-based cross-sectional study performed in 2010, a passive, multimodal intervention, focused on improving adherence to HBPM guidelines, was implemented. A second study was conducted in 2014 to measure its effect.

Results: In 2010 and 2014, 1010 and 1005 patients, respectively, completed the questionnaire. In 2010 and 2014, 82% and 84% of patients, respectively, self-measured their BP. Reporting of HBPM and adherence to recommended procedures was suboptimal. Only 34.0% of patients in 2010 and 31.7% in 2014 brought > 80% of their measurements to their doctor. Only 49.6% in 2010 and 52.9% in 2014 prepared > 80% of the time for HBPM. Only 48.1% in 2010 and 52.1% in 2014 rested for 5 minutes > 80% of the time before HBPM. Only 15% of patients in 2010 and 18% in 2014 were defined as sufficiently compliant with all HBPM procedures. Paired analysis of a subset of 535 patients who participated in the 2010 and 2014 studies showed no clinically significant differences in reliability between the 2 surveys.

Conclusions: Adherence to HBPM guidelines was suboptimal in 2010 and still is in 2014 despite a passive, multimodal intervention. Active training in HBPM procedures should be studied. Greater automation could improve HBPM reliability.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Blood Pressure Determination / standards*
  • Blood Pressure Determination / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Guidelines as Topic
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Patient Education as Topic / methods
  • Quebec
  • Reproducibility of Results
  • Risk Assessment
  • Self Care / standards*
  • Self Care / trends
  • Sensitivity and Specificity
  • Sex Factors
  • Surveys and Questionnaires