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Home blood pressure monitoring improves hypertension control and reduces medical costs, according to the results of a pilot initiative presented at the 2018 joint scientific sessions on hypertension. American Heart Association.
The guidelines from the American Heart Association and the American College of Cardiology emphasize the importance of home blood pressure monitoring for optimal hypertension management.
However, according to Roy R. Champion, M.Sc., BSN, RN Clinical Quality At the Scott and White Health Plan, in Temple, Texas, monitoring of home blood pressure is not part of most treatment plans . Based on the trends observed in medical chart reviews, Champion said that less than one in five providers included home blood pressure monitoring in documentation for patients with hypertension.
"Meanwhile, in charts that used home blood pressure monitoring, about 86% of these patients had their hypertension under control," Champion said.
Home monitoring combined with doctor visits to measure a patient's blood pressure helps avoid the numbers distorted by "white hypertension" when blood pressure is elevated in a medical setting but not in everyday life and masked hypertension. normal in a medical setting but raised at home.
Champion investigated the impact of an intervention that provided free home blood pressure monitors, online and print resources to track their readings, and monitored recalls to 2,550 adult patients with persistent, uncontrolled high blood pressure. In each case, the patient's provider should know that the patient has received a free home blood pressure monitor and resources on how to use it.
They found:
- During their third visit to the office, nearly 67% of patients had their blood pressure checked.
- Nearly 60% of patients had blood pressure control on their sixth visit.
Champion attributed the decline of the third to the sixth visit to the blood pressure adjusting medications providers based on information provided by home blood pressure monitoring. Patients only had to see their doctors a few times to determine the ideal amount of medication, he said.
- By the end of the intervention, systolic blood pressure had decreased by an average of 16.9 mmHg and diastolic blood pressure had decreased by an average of 6.5 mmHg.
- Within six months of the intervention, nearly 80% of participants managed to control their blood pressure using the HEDIS (Healthcare Effectiveness Data and Information Set) 2018 standards.
- Using the 2017 AHA / ACC guidelines, 72 percent achieved control of hypertension.
"Even with the strictest guidelines, we have shown that home blood pressure monitoring is essential for controlling hypertensive patients," said Champion.
- Each kit, including the monitor, costs an average of $ 38.50; however, the savings achieved through the intervention have been considerable. The intervention has reduced the required office visits by 1.2 visits per participant per year and significantly reduced the costs associated with emergency services and medication.
Home monitoring helps providers better understand patients' blood pressure figures in a cost-effective manner, without increasing the burden on patients or providers, Champion said.
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