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Current Hypertension Reports

, Volume 15, Issue 4, pp 346–355 | Cite as

The Role of Home Blood Pressure Telemonitoring in Managing Hypertensive Populations

  • Leah L. ZulligEmail author
  • S. Dee Melnyk
  • Karen Goldstein
  • Ryan J. Shaw
  • Hayden B. Bosworth
Hypertension and the Heart (PW de Leeuw and AH Gradman, Section Editors)

Abstract

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.

Keywords

Hypertension Blood pressure monitoring Telephone Home-based telemonitoring Technology Intervention Behavioral modification Medication management Healthcare costs Patient-centric care 

Notes

Acknowledgments

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.

References

  1. 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
  2. 2.
    Guo F, He D, Zhang W, Walton RG. Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010. J Am Coll Cardiol. 2012;60(7):599–606.PubMedCrossRefGoogle Scholar
  3. 3.
    Patel B, Turban S, Anderson C, Charleston J, Miller ER, Appel LJ. A comparison of web sites used to manage and present home blood pressure readings. J Clin Hypertens (Greenwich, Conn). 2010;12(6):389–95.CrossRefGoogle Scholar
  4. 4.
    Fisher ES. Building a medical neighborhood for the medical home. N Engl J Med. 2008;359(12):1202–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Joint principles of the patient-centered medical home [http://www.medicalhomeinfo.org/JointStatement.pdf]
  6. 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
  7. 7.
    Rosenthal TC. The medical home: growing evidence to support a new approach to primary care. J Am Board Family Med: JABFM. 2008;21(5):427–40.PubMedCrossRefGoogle Scholar
  8. 8.
    Friedman RH, Kazis LE, Jette A, Smith MB, Stollerman J, Torgerson J, et al. A telecommunications system for monitoring and counseling patients with hypertension. Impact on medication adherence and blood pressure control. Am J Hypertens. 1996;9(4 Pt 1):285–92.PubMedCrossRefGoogle Scholar
  9. 9.
    Pinto BM, Friedman R, Marcus BH, Kelley H, Tennstedt S, Gillman MW. Effects of a computer-based, telephone-counseling system on physical activity. Am J Prev Med. 2002;23(2):113–20.PubMedCrossRefGoogle Scholar
  10. 10.
    Bosworth HB, Olsen MK, Gentry P, Orr M, Dudley T, McCant F, et al. Nurse administered telephone intervention for blood pressure control: a patient-tailored multifactorial intervention. Patient Educ Couns. 2005;57(1):5–14.PubMedCrossRefGoogle Scholar
  11. 11.
    Friedman RH. Automated telephone conversations to assess health behavior and deliver behavioral interventions. J Med Syst. 1998;22(2):95–102.PubMedCrossRefGoogle Scholar
  12. 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.
  13. 13.
    Datta SK, Oddone EZ, Olsen MK, Orr M, McCant F, Gentry P, et al. Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients. Am Hear J. 2010;160(2):257–63.CrossRefGoogle Scholar
  14. 14.
    Lovibond K, Jowett S, Barton P, Caulfield M, Heneghan C, Hobbs FD, et al. Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study. Lancet. 2011;378(9798):1219–30.PubMedCrossRefGoogle Scholar
  15. 15.
    Madsen LB, Christiansen T, Kirkegaard P, Pedersen EB. Economic evaluation of home blood pressure telemonitoring: a randomized controlled trial. Blood Press. 2011;20(2):117–25.PubMedCrossRefGoogle Scholar
  16. 16.
    Reed SD, Li Y, Oddone EZ, Neary AM, Orr MM, Grubber JM, et al. Economic evaluation of home blood pressure monitoring with or without telephonic behavioral self-management in patients with hypertension. Am J Hypertens. 2010;23(2):142–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Wang V, Smith VA, Bosworth HB, Oddone EZ, Olsen MK, McCant F, et al. Economic evaluation of telephone self-management interventions for blood pressure control. Am Hear J. 2012;163(6):980–6.CrossRefGoogle Scholar
  18. 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. 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
  20. 20.
    Pickering T. White coat hypertension’–should it be treated or not? Cleve Clin J Med. 2002;69(8):584–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Powers BJ, Olsen MK, Smith VA, Woolson RF, Bosworth HB, Oddone EZ. Measuring blood pressure for decision making and quality reporting: where and how many measures? Ann Intern Med. 2011;154(12):781–8. W-289-790.PubMedCrossRefGoogle Scholar
  22. 22.
    Bosworth HB, Olsen MK, Grubber JM, Neary AM, Orr MM, Powers BJ, et al. Two self-management interventions to improve hypertension control: a randomized trial. Ann Intern Med. 2009;151(10):687–95.PubMedCrossRefGoogle Scholar
  23. 23.
    Chiu CW, Wong FK. Effects of 8 weeks sustained follow-up after a nurse consultation on hypertension: a randomised trial. Int J Nurs Stud. 2010;47(11):1374–82.PubMedCrossRefGoogle Scholar
  24. 24.
    Hebert PL, Sisk JE, Tuzzio L, Casabianca JM, Pogue VA, Wang JJ, et al. Nurse-led disease management for hypertension control in a diverse urban community: a randomized trial. J Gen Intern Med. 2012;27(6):630–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Kerby TJ, Asche SE, Maciosek MV, O’Connor PJ, Sperl-Hillen JM, Margolis KL. Adherence to blood pressure telemonitoring in a cluster-randomized clinical trial. J Clin Hypertens (Greenwich, Conn). 2012;14(10):668–74.CrossRefGoogle Scholar
  26. 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. 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
  28. 28.
    Magid DJ, Ho PM, Olson KL, Brand DW, Welch LK, Snow KE, et al. A multimodal blood pressure control intervention in 3 healthcare systems. Am J Manag Care. 2011;17(4):e96–103.PubMedGoogle Scholar
  29. 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
  30. 30.
    Wakefield BJ, Holman JE, Ray A, Scherubel M, Adams MR, Hills SL, et al. Outcomes of a home telehealth intervention for patients with diabetes and hypertension. Telemed J e-health: Off J Am Telemed Assoc. 2012;18(8):575–9.CrossRefGoogle Scholar
  31. 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
  32. 32.
    Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V, et al. Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Arch Intern Med. 2011;171(13):1173–80.PubMedCrossRefGoogle Scholar
  33. 33.
    DeBusk RF, Houston Miller N, West JA. Diabetes case management. Ann Intern Med. 1999;130(10):863.PubMedCrossRefGoogle Scholar
  34. 34.
    DeBusk RF, West JA, Miller NH, Taylor CB. Chronic disease management: treating the patient with disease(s) vs treating disease(s) in the patient. Arch Intern Med. 1999;159(22):2739–42.PubMedCrossRefGoogle Scholar
  35. 35.
    Santschi V, Chiolero A, Burnand B, Colosimo AL, Paradis G. Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials. Arch Intern Med. 2011;171(16):1441–53.PubMedCrossRefGoogle Scholar
  36. 36.
    Harris IM, Baker E, Berry TM, Halloran MA, Lindauer K, Ragucci KR, et al. Developing a Business-Practice Model for Pharmacy Services in Ambulatory Settings. Pharmacotherapy. 2008;28(2):7e–34e.CrossRefGoogle Scholar
  37. 37.
    Burke JM, Miller WA, Spencer AP, Crank CW, Adkins L, Certch KE, et al. Clinical Pharmacist Competencies. Pharmacotherapy. 2008;28(6):806–15.PubMedCrossRefGoogle Scholar
  38. 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. 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. 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
  41. 41.
    Rothman RL, Malone R, Bryant B, Shintani AK, Crigler B, Dewalt DA, et al. A randomized trial of a primary care-based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes. Am J Med. 2005;118(3):276–84.PubMedCrossRefGoogle Scholar
  42. 42.
    Taveira TH, Wu WC, Martin OJ, Schleinitz MD, Friedmann P, Sharma SC. Pharmacist-led cardiac risk reduction model. Prev Cardiol. 2006;9(4):202–8.PubMedCrossRefGoogle Scholar
  43. 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
  44. 44.
    van Dalem J, Krass I, Aslani P. Interventions promoting adherence to cardiovascular medicines. Int J Clin Pharm. 2012;34(2):295–311.PubMedCrossRefGoogle Scholar
  45. 45.
    Logan AG, Irvine MJ, McIsaac WJ, Tisler A, Rossos PG, Easty A, et al. Effect of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics. Hypertension. 2012;60(1):51–7.PubMedCrossRefGoogle Scholar
  46. 46.
    Resnick HE, Ilagan PR, Kaylor MB, Mehling D, Alwan M. TEAhM-Technologies for Enhancing Access to Health Management: a pilot study of community-based telehealth. Telemed J e-health: Off J Am Telemed Assoc. 2012;18(3):166–74.CrossRefGoogle Scholar
  47. 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
  48. 48.
    Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, et al. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA: J Am Med Assoc. 2008;299(24):2857–67.CrossRefGoogle Scholar
  49. 49.
    Green BB, Ralston JD, Fishman PA, Catz SL, Cook A, Carlson J, et al. Electronic communications and home blood pressure monitoring (e-BP) study: design, delivery, and evaluation framework. Contemp Clin Trials. 2008;29(3):376–95.PubMedCrossRefGoogle Scholar
  50. 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. 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
  52. 52.
    Katz SJ, Moyer CA. The emerging role of online communication between patients and their providers. J Gen Intern Med. 2004;19(9):978–83.PubMedCrossRefGoogle Scholar
  53. 53.
    McGeady D, Kujala J, Ilvonen K. The impact of patient-physician web messaging on healthcare service provision. Intern J Med Inform. 2008;77(1):17–23.CrossRefGoogle Scholar
  54. 54.
    Eysenbach G. What is e-health? J Med Internet Res. 2001;3(2):E20.PubMedCrossRefGoogle Scholar
  55. 55.
    Green BB, Anderson ML, Ralston JD, Catz S, Fishman PA, Cook AJ. Patient ability and willingness to participate in a web-based intervention to improve hypertension control. J Med Internet Res. 2011;13(1):e1.PubMedCrossRefGoogle Scholar
  56. 56.
    Adie K, James MA. Does telephone follow-up improve blood pressure after minor stroke or TIA? Age Ageing. 2010;39(5):598–603.PubMedCrossRefGoogle Scholar
  57. 57.
    Shaw R, Bosworth HB. Baseline medication adherence and blood pressure in a 24-month longitudinal hypertension study. J Clin Nurs. 2012;21(9–10):1401–6.PubMedCrossRefGoogle Scholar
  58. 58.
    Bodenheimer T, Pham HH. Primary care: current problems and proposed solutions. Health Aff (Project Hope). 2010;29(5):799–805.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York (outside the USA) 2013

Authors and Affiliations

  • Leah L. Zullig
    • 1
    • 2
    Email author
  • S. Dee Melnyk
    • 1
    • 3
    • 4
  • Karen Goldstein
    • 1
    • 4
    • 5
  • Ryan J. Shaw
    • 1
  • Hayden B. Bosworth
    • 1
    • 5
    • 6
  1. 1.Center of Excellence for Health Services Research in Primary CareDurham Veterans Affairs Medical CenterDurhamUSA
  2. 2.Department of Health Policy and ManagementUniversity of North CarolinaChapel HillUSA
  3. 3.University of North Carolina Eshelman School of PharmacyChapel HillUSA
  4. 4.Ambulatory Care ServicesDurham Veterans Affairs Medical CenterDurhamUSA
  5. 5.Division of General Internal MedicineDuke UniversityDurhamUSA
  6. 6.Departments of Psychiatry and School of NursingDuke UniversityDurhamUSA

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