Daily usage and efficiency of remote home monitoring in hypertensive patients over a one-year period

Port, Kristjan; Palm, Kairit; Viigimaa, Margus

doi:10.1258/1357633054461705

Cited by 32 publications

(24 citation statements)

References 14 publications

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“…A lack of motivation was not considered to be a major barrier based on their analysis. 13 In contrast, our study found the most prevalent personal factors affecting nonusage of HBP monitors were forgetting, not having time, and self-described laziness. This suggests HBPM was not a lifestyle priority to subjects, and a lack of motivation does contribute to nonparticipation in HBPM.…”

Section: Discussioncontrasting

confidence: 85%

“…Thought they had reported through central system (4) Didn't receive automated reminders (2) System took too long (16) Lost pin/password (6) Never received feedback report (5) Didn't receive response aŌer eliciƟng help from system (3) Concerned over accuracy of cuff (17) Didn't take BPs oŌen enough Concerned over accuracy of cuff (2) Cuff didn't work (14) Didn't know how to use cuff/experienced problems with cuff Didn't know how to use cuff (13) Concerned over accuracy of cuff Disliked cuff (1) Didn't have baƩeries (1) Had normal BP (43) Had normal BP (27) Felt like office readings were sufficient/superior (22) Thought office readings were sufficient/superior (15) Was unaware of reporƟng system (21) Had normal BP (11) Didn't have symptoms of hypertension (9) Didn't know how to report (20) Thought it wasn't important (4) Didn't know how to report (7) Thought office readings were sufficient/superior (11) Had high BP (1) Felt that less frequent monitoring was sufficient (4) Didn't understand the benefit (10) Had too few BPs (1) Didn't know (18) Didn't know (20) Didn't know (9) Other (4) Other (3) Other (3) * n=responses; mulƟple responses allowed for each quesƟon; percentages total more than 100% with a HBP reporting system. We found that the majority of nonreporters (70.2%) still used their HBP cuffs despite not reporting through the central system.…”

Section: Discussionmentioning

confidence: 99%

“…After the 1-year trial, only half of the study population were willing to continue HBPM. 13 This descriptive study evaluated the utility and validity of HBPM and did not describe barriers to participation. Nonparticipation is not unique to HBPM.…”

mentioning

confidence: 99%

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What Keeps Patients from Adhering to a Home Blood Pressure Program?

Huff¹,

Zittleman²,

DeAlleaume³

et al. 2011

The Journal of the American Board of Family Medicine

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Background: Home blood pressure monitoring (HBPM) predicts cardiovascular risk and increases hypertension control. Non-participation in HBPM is prevalent and decreases the potential benefit.Methods: Telephone surveys were conducted with a random quota sample of non-participants in a HBPM program, which supplied a complimentary automated blood pressure cuff and utilized a centralized reporting system. Questioning assessed use of monitors, perceived benefit, communication with providers, and barriers.Results: There were 320 completed surveys (response rate 53%). Of non-participants, 70.2% still used HBPM cuffs and 58% communicated values to providers. Spanish-speakers were 4.4 times more likely to not use cuffs (95% CI, 2.22-8.885). Barriers to participation were largely personal (forgetting, not having time, or self-described laziness). Reasons for not communicating readings with providers were largely clinic factors (no doctor visit, doctor didn't ask, thinking doctor wouldn't care). Lack of knowledge of HBPM and program design also contributed. After being surveyed, patients were over three times more likely to use the central reporting system. Discussion: Most non-participants still used HBPM and communicated values to providers, suggesting many "drop-outs" may still receive clinical benefit. However, much valuable information is not utilized. Future programs should focus on reminder systems, patient motivation, education, and minimizing time involvement.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What Keeps Patients from Adhering to a Home Blood Pressure Program?

Huff¹,

Zittleman²,

DeAlleaume³

et al. 2011

The Journal of the American Board of Family Medicine

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“…156 A 1-year experience with HBPM combined with telephone transmission to a central server and reports to treating physicians found that initial enthusiasm for HBPM was followed by a decrease in use, so that only 50% preferred to continue HBPM for the second year. 157 A survey comparing patients' attitudes with different methods of obtaining accurate BP measurements found that HBPM was preferred over other methods (which included ABPM and measurement by either the physician or nurse in the office). 158 Will patients want to pay for HBPM as an add-on for management?…”

Section: Cost Of Home Bp Devicesmentioning

confidence: 99%

Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Pickering¹,

Miller

Ogedegbe³

et al. 2008

Hypertension

487

235

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Abstract-Home blood pressure monitoring (HBPM) overcomes many of the limitations of traditional office blood pressure (BP) measurement and is both cheaper and easier to perform than ambulatory BP monitoring. Monitors that use the oscillometric method are currently available that are accurate, reliable, easy to use, and relatively inexpensive. An increasing number of patients are using them regularly to check their BP at home, but although this has been endorsed by national and international guidelines, detailed recommendations for their use have been lacking. There is a rapidly growing literature showing that measurements taken by patients at home are often lower than readings taken in the office and closer to the average BP recorded by 24-hour ambulatory monitors, which is the BP that best predicts cardiovascular risk. Because of the larger numbers of readings that can be taken by HBPM than in the office and the elimination of the white-coat effect (the increase of BP during an office visit), home readings are more reproducible than office readings and show better correlations with measures of target organ damage. In addition, prospective studies that have used multiple home readings to express the true BP have found that home BP predicts risk better than office BP (Class IIa; Level of Evidence A). This call-to-action article makes the following recommendations: (1) It is recommended that HBPM should become a routine component of BP measurement in the majority of patients with known or suspected hypertension; (2) Patients should be advised to purchase oscillometric monitors that measure BP on the upper arm with an appropriate cuff size and that have been shown to be accurate according to standard international protocols. They should be shown how to use them by their healthcare providers; (3) Two to 3 readings should be taken while the subject is resting in the seated position, both in the morning and at night, over a period of 1 week. A total of Ն12 readings are recommended for making clinical decisions; (4) HBPM is indicated in patients with newly diagnosed or suspected hypertension, in whom it may distinguish between white-coat and sustained hypertension. If the results are equivocal, ambulatory BP monitoring may help to establish the diagnosis; (5) In patients with prehypertension, HBPM may be useful for detecting masked hypertension; (6) HBPM is recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence; (7) The target HBPM goal for treatment is Ͻ135/85 mm Hg or Ͻ130/80 mm Hg in high-risk patients; (8) HBPM is useful in the elderly, in whom both BP variability and the white-coat effect are increased; (9) HBPM is of value in patients with diabetes, in whom tight BP control is of paramount importance; (10) Other populations in whom HBPM may be beneficial include pregnant women, children, and patients with kidney disease; and (11) HBPM has the potential to improve the quality of care while reducing costs and should be reimbursed. (Hypertension. 2008;52:10-29.)

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“…Other studies on the compliance and effectiveness of at home telemonitoring [27] report that over one year compliance rates with recording weight was 75% and for the recording of blood pressure, 90%, whilst another study [28] reports values of 12-75% for compliance with daily weighing for CHF patients. According to Maeder et al, [6], reported levels of compliance varied from approximately 40% to 90%.…”

Section: Introductionmentioning

confidence: 99%

Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

Celler¹,

Argha²,

Varnfield³

et al. 2017

Preprint

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Background This paper presents findings on patient compliance with scheduled vital signs measurements in the recently completed Commonwealth Scientific and Industrial Research Organization (CSIRO) national trial of home telemonitoring of patients with chronic conditions, carried out at five locations along the east coast of Australia. ObjectivesTo investigate the ability of chronically ill patients to carry out a daily schedule of vital signs measurements as part of a chronic disease management care plan, over prolonged periods exceeding six months, and to explore different levels of compliance for different measurements, as a function of age, gender and supervisory models. MethodsPatients were required to monitor on a daily basis a range of vital signs determined by their chronic condition and co-morbidities. Vital signs included non-invasive blood pressure, pulse oximetry, spirometry, ECG, blood glucose level, body temperature and body weight.Compliance was calculated as the number days during which at least one measurement was taken over all days where measurements were scheduled. ResultsPatients were monitored on average for 302 days although some continued beyond 12 months. The overall compliance rate for all measurements was 64.8%. The compliance rates of patients monitored in hospital settings relative to those monitored in community settings were significantly higher for spirometry (69.3 versus 41.0%, p<0.001), body weight (64.5 versus 40.5%, p=<0.001) and body temperature (66.8 versus 55.2%, p=0.026), and the compliance rates for blood pressure (68.5 versus 59.7%, p=0.042), ECG (65.6 versus 56.5%, p=0.047) and pulse oximetry (67.0 versus 56.4%, p=0.018) were significantly higher in male relative to female subjects. Compliance with blood glucose measurements (58.1 versus 50.2%, p=0.237) was not significantly different overall. No statistical differences were observed between rates of compliance for younger patients group (≤70 years old) and older patient group (>70 yo). ConclusionsPatients with chronic conditions were able to record their vital signs at home at least once every two days over prolonged periods of time. Surprisingly, male patients maintained a higher compliance than female patients over time, and patients supervised by hospital based care coordinators reported higher levels of compliance with their measurement schedule relative to patients supervised in community settings. This was most noticeable for spirometry.

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Daily usage and efficiency of remote home monitoring in hypertensive patients over a one-year period

Cited by 32 publications

References 14 publications

What Keeps Patients from Adhering to a Home Blood Pressure Program?

What Keeps Patients from Adhering to a Home Blood Pressure Program?

Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

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