Effect of Home Blood Pressure Monitoring on Patient’s Awareness and Goal Attainment Under Antihypertensive Therapy: The Factors Influencing Results in Anti-HypertenSive Treatment (FIRST) Study

Spirk, David; Noll, Sarah; Burnier, Michel; Rimoldi, Stefano F.; Noll, Georg; Sudano, Isabella

doi:10.1159/000490687

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…Why a high-intensity intervention is required in patients with cerebrovascular disease is unknown. SMBP is expected to improve awareness of hypertension 38,39 and reduce therapeutic inertia, 40 but in our study half of the subjects who believed their BP was well controlled had an average SBP >140 over the last 7 days of monitoring. These patients seemed to have a lack of awareness despite specific education and feedback after each individual BP check and in automated weekly communications.…”

Section: Discussionmentioning

confidence: 64%

Randomized Trial of a Social Support Intervention to Improve Home Blood Pressure Monitoring in Patients With Cerebrovascular Disease

Mullen,

Cucchiara,

Messé

et al. 2023

The Neurologist

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Background: A pilot randomized trial evaluating whether a social support intervention improves adherence to home blood pressure (BP) monitoring among patients with cerebrovascular disease. Methods: Subjects with ischemic stroke, intracerebral hemorrhage, or transient ischemic attack within 5 years with BP >140/90, were given a centrally monitored home BP cuff and asked to check their BP twice a day for 90 ± 7 days. Subjects received text and/or email reminders for missed measurements and weekly reports on adherence/BP control. Subjects were randomized 1:1 to a social support intervention, in which close personal contact also received all study-related education and communications. The primary outcome was the proportion of requested measurements completed. A secondary outcome was a change in BP over time. Results: Thirty-three subjects were enrolled, 15 in the control arm and 18 in the social support arm. The social support arm completed a greater proportion of BP measurements at day 30 (88% vs 78%), day 60 (72% vs 54%), and day 83 (60% vs 40%), but none of these differences were statistically significant (P > 0.05). Comparing the first 7 days of BP readings to the last 7 days across subjects, there was a nonsignificant decrease in BP over time (systolic BP = −2.8 mm Hg, P = 0.29 and diastolic BP = −1.7, P = 0.36). The social support intervention did not modify the change in BP over time. Conclusion: A social support intervention may increase adherence to home BP monitoring. This pilot study provides important preliminary data to inform the design of larger more definitive trials utilizing self-monitoring of BP in patients with cerebrovascular disease.

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Section: Discussionmentioning

confidence: 64%

Randomized Trial of a Social Support Intervention to Improve Home Blood Pressure Monitoring in Patients With Cerebrovascular Disease

Mullen,

Cucchiara,

Messé

et al. 2023

The Neurologist

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“…Among the 1258 participants, 455 (36.2%), 572 (45.5%), and 659 (52.4%) did not measure HBP during the 4-, 8-, and 12-week follow-up, respectively. Compared to compliance in previous studies on HBP compliance and BP control (91.0% measured their BP at least > 12 times per week), the compliance in this study is much lower [32]. Third, we did not plan to survey positive effects of HBP other than BP control, such as improving medication adherence or awareness in patients or medication titration by physicians.…”

Section: Discussionmentioning

confidence: 73%

Effect of home blood pressure monitoring for blood pressure control in hypertensive patients taking multiple antihypertensive medications including fimasartan (the FORTE study)

Choi

Kim

2020

Clin Hypertens

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Background Although recent hypertension guidelines recommend home blood pressure (HBP) monitoring, its effect in clinical practice is not well known. This study aimed to identify current HBP measurement status and obstacles and their efficacy on blood pressure (BP) control. Methods Sixty-three intervention and 61 control centers with 2483 (mean age: 58.0 years, 56.0% male) drug-naïve stage 2 hypertensive patients or patients requiring second anti-hypertensive medications were included. The intervention group was instructed to measure HBP twice a day for 7 days from the scheduled visit at 4, 8, and 12 weeks. Results At the end of 12 weeks, 842 (68.7%) and 807 (64.15%) patients of the control and intervention groups, respectively, achieved a target BP. The odds ratio (OR) for improving BP control of HBP was 0.836 (95% confidence interval [CI]: 0.694–1.007). Among intervention group, clinic BP of the subgroup those measured their HBP at least once well controlled compared to subgroup those not measured their HBP at all (OR 1.602, 95% CI: 1.182–2.172). Only 19.17% (n = 476) had a home sphygmomanometer, and among those, 26.89% measured their BP at least once a week and 34.87% did not measure the BP at all. The obstacles of HBP measurement were lack of awareness of its importance (40.83%), lack of confidence on how to measure BP and maintain the measurement (37.04%), and difficulty in selecting an appropriate device (14.41%). Conclusions HBP measurement alone did not improve BP control, but better compliance with the HBP measurement resulted in improved BP control. Trial registration ClinicalTrials, NCT03254914, Registered 21 August 2017.

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“…Increasing patient's awareness of their condition and BP through education and engagement may also decrease BP. 3,4 Office readings only provide a brief glimpse at a patient's overall HTN control. Self-monitoring blood pressure (SMBP), or home monitoring, is a tool that helps patients with HTN monitor BP outside of the office, providing more data for their provider to make clinical decisions.…”

Section: Introductionmentioning

confidence: 99%

“…Increasing patient’s awareness of their condition and BP through education and engagement may also decrease BP. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Improving Access to Home Blood Pressure Monitors at a Federally Qualified Health Center

Deshpande

Kanwar

Swyers

et al. 2023

Journal of Pharmacy Technology

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Background: Self-monitoring of blood pressure (BP) clinically decreases BP. However, cost can limit access, especially in underserved populations. Objective: This mixed-methods pilot study aims to determine the impact of providing home BP monitors free of charge to patients at a federally qualified health center (FQHC) by quantifying the effect on BP and surveying patients to measure satisfaction and engagement. Methods: One hundred eighty patients with clinically diagnosed hypertension received BP monitors. Patient charts were reviewed to collect demographics and office BP readings 3 months before and after receiving a monitor. A 13-question phone survey was conducted to a sample of patients addressing satisfaction and engagement. Answers were based on a Likert scale and dichotomous yes/no. Results were analyzed with descriptive statistics and paired t tests. Results: The chart review demonstrated a significant mean decrease in systolic BP by 5.44 mm Hg ( P < 0.001, −8.03 to −2.84) and a mean decrease in diastolic BP by 2.70 mm Hg ( P < 0.001, −4.08 to −1.32) after the intervention. For those included who responded to the survey (13%), there was a significant mean increase in the frequency of checking BP per week by 1.5 Likert points ( P < 0.00001, −1.0 to −1.9), and a majority (57.8%) felt slightly or much more active in their health care in addition to other benefits. Conclusion: Providing BP monitors to FQHC patients free of charge may have contributed to a significantly decreased office BP, improved engagement, and satisfaction. This program removed cost barriers and allowed patients to be more active in their health care.

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Effect of Home Blood Pressure Monitoring on Patient’s Awareness and Goal Attainment Under Antihypertensive Therapy: The Factors Influencing Results in Anti-HypertenSive Treatment (FIRST) Study

Cited by 12 publications

References 18 publications

Randomized Trial of a Social Support Intervention to Improve Home Blood Pressure Monitoring in Patients With Cerebrovascular Disease

Randomized Trial of a Social Support Intervention to Improve Home Blood Pressure Monitoring in Patients With Cerebrovascular Disease

Effect of home blood pressure monitoring for blood pressure control in hypertensive patients taking multiple antihypertensive medications including fimasartan (the FORTE study)

Improving Access to Home Blood Pressure Monitors at a Federally Qualified Health Center

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