Clinical Implementation of Self-Measured Blood Pressure Monitoring, 2015-2016

Abstract

Introduction: Self-measured blood pressure monitoring (SMBP) plus additional clinical support is an evidence-based strategy that improves blood pressure control. Despite national recommendations for SMBP use and potential cost savings, insurance coverage for implementation is limited in the U.S. and little is known regarding clinical implementation.

Methods: In 2017, using 2015 and 2016 DocStyles survey data from 1,590 primary care physicians and nurse practitioners in U.S. outpatient facilities, SMBP-related clinical practices and provider roles were assessed.

Results: Almost all (97%) respondents reported using SMBP. Among 1,539 who used SMBP, more than half (60%) used SMBP for a combination of diagnostic and treatment purposes, whereas 24% used SMBP for diagnosis only and 16% used SMBP for treatment only. The most common methods for patients to share SMBP results with clinical staff were paper log (68%); during appointments (66%); by telephone (37%); by secure website (22%); or by secure e-mail (19%). Nearly all (98%) respondents reported that medication adjustments were provided to patients based on SMBP readings. About 15% did not counsel patients regarding cuff size, and 8% did not validate patient devices. Only 13% of respondents reported having monitor loaner programs, and availability did not vary by the financial status of the patient population (p=0.59).

Conclusions: SMBP is used widely in outpatient facilities as reported in the survey, although provider roles and SMBP-related practices vary, and gaps exist regarding patient counseling, device validation, and loaner program availability. As part of efforts to improve hypertension control, healthcare professionals can promote increased use of best practices for SMBP, whereas insurers can implement standardization and support of SMBP.

Figure 1.

Respondent perceptions of who is responsible for SMBP-related activities – DocStyles 2015 and 2016.