The Role of Home Blood Pressure Telemonitoring in Managing Hypertensive Populations
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Hypertension is a common chronic disease affecting nearly one-third of the United States population. Many interventions have been designed to help patients manage their hypertension. With the evolving climate of healthcare, rapidly developing technology, and emphasis on delivering patient-centered care, home-based blood pressure telemonitoring is a promising tool to help patients achieve optimal blood pressure (BP) control. Home-based blood pressure telemonitoring is associated with reductions in blood pressure values and increased patient satisfaction. However, additional research is needed to understand cost-effectiveness and long-term clinical outcomes of home-based BP monitoring. We review key interventional trials involving home based BP monitoring, with special emphasis placed on studies involving additionally behavioral modification and/or medication management. Furthermore, we discuss the role of home-based blood pressure telemonitoring within the context of the patient-centered medical home and the evolving role of technology.
KeywordsHypertension Blood pressure monitoring Telephone Home-based telemonitoring Technology Intervention Behavioral modification Medication management Healthcare costs Patient-centric care
Dr. Zullig is supported by funding from the National Cancer Institute (5R25CA116339). Dr. Bosworth was supported by a research career scientist award from the VA Health Service Research and Development (VA HSR&D 08–027). Dr. Shaw was supported by Health Services Research and Development Service, Department of Veterans Affairs, Office of Academic Affiliations (TPP-21-021). The content is solely the responsibility of the authors and does not necessarily represent the views US Department of Veterans Affairs.
Conflict of Interest
L.L. Zullig declares that she has no conflict of interest.
S.D. Melnyk declares that she has no conflict of interest.
K. Goldstein declares that she has no conflict of interest.
R.J. Shaw declares that he has no conflict of interest.
H.B. Bosworth declares that he has no conflict of interest.
- 1.Vital signs: prevalence, treatment, and control of hypertension--United States, 1999–2002 and 2005–2008. MMWR Morb Mortal Wkly Rep. 2011;60(4):103–8.Google Scholar
- 5.Joint principles of the patient-centered medical home [http://www.medicalhomeinfo.org/JointStatement.pdf]
- 6.Jackson GL, Powers BJ, Chatterjee R, Prvu Bettger J, Kemper AR, Hasselblad V, et al. The patient-centered medical home: a systematic review. Ann Intern Med. 2013;158(3):169–178.Google Scholar
- 12.Cottrell E, McMillan K, Chambers R. A cross-sectional survey and service evaluation of simple telehealth in primary care: what do patients think? BMJ Open. 2012;2(6):e001392. doi: 10.1136/bmjopen-2012-001392.
- 18.Staessen JA, Thijs L, Fagard R, O’Brien ET, Clement D, de Leeuw PW, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA. 1999;282(6):539–46.PubMedCrossRefGoogle Scholar
- 19.Turnbull SM, Magennis SP, Turnbull CJ. Patient self-monitoring of blood pressure in general practice: the ‘inverse white-coat’ response. British J G Prac: J Royal Coll Gen Pract. 2003;53(488):221–3.Google Scholar
- 26.Kerry SM, Markus HS, Khong TK, Cloud GC, Tulloch J, Coster D, et al. Home blood pressure monitoring with nurse-led telephone support among patients with hypertension and a history of stroke: a community-based randomized controlled trial. CMAJ. 2013;185(1):23–31. doi: 10.1503/cmaj.120832.
- 27.Kim MT, Han HR, Hedlin H, Kim J, Song HJ, Kim KB, et al. Teletransmitted monitoring of blood pressure and bilingual nurse counseling-sustained improvements in blood pressure control during 12 months in hypertensive Korean Americans. J Clin Hypertens (Greenwich, Conn). 2011;13(8):605–12.CrossRefGoogle Scholar
- 29.Melnyk SD, Zullig LL, McCant F, Danus S, Oddone E, Bastian L, Olsen M, Stechuchak KM, Edelman D, Rakley S et al. Telemedicine Cardiovascular Risk Reduction Intervention in Veterans. Am Heart J. 2013;165(4)501–8.Google Scholar
- 31.Carter BL, Bosworth HB, Green BB. The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. Journal of clinical hypertension (Greenwich, Conn). 2012, 14(1):51–65.Google Scholar
- 38.Carter BL, Bergus GR, Dawson JD, Farris KB, Doucette WR, Chrischilles EA, Hartz AJ. A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control. Journal of clinical hypertension. (Greenwich, Conn) 2008, 10(4):260–271.Google Scholar
- 39.Gattis WA, Hasselblad V, Whellan DJ, O’Connor CM. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study. Arch Intern Med. 1999;159(16):1939–45.PubMedCrossRefGoogle Scholar
- 40.McLean DL, McAlister FA, Johnson JA, King KM, Makowsky MJ, Jones CA, et al. A randomized trial of the effect of community pharmacist and nurse care on improving blood pressure management in patients with diabetes mellitus: study of cardiovascular risk intervention by pharmacists-hypertension (SCRIP-HTN). Arch Intern Med. 2008;168(21):2355–61.PubMedCrossRefGoogle Scholar
- 43.Tsuyuki RT, Johnson JA, Teo KK, Simpson SH, Ackman ML, Biggs RS, et al. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Arch Intern Med. 2002;162(10):1149–55.PubMedCrossRefGoogle Scholar
- 47.Tsuyuki RT, Houle SKD. 13 Opportunities to Improve Hypertension Care in the Community: An Analysis of Over 8 Million Pharmacy-Based Blood Pressure Kiosk Readings. Journal of Hypertension. 2012, 30(e1).Google Scholar
- 50.Morikawa N, Yamasue K, Tochikubo O, Mizushima S. Effect of salt reduction intervention program using an electronic salt sensor and cellular phone on blood pressure among hypertensive workers. Clinical and experimental hypertension. (New York, NY : 1993) 2011, 33(4):216–222.Google Scholar
- 51.Shaw RJ, Johnson CM. Health Information Seeking and Social Media Use on the Internet among People with Diabetes. Online journal of public health informatics. 2011, 3(1).Google Scholar