Daily usage and efficiency of remote home monitoring in hypertensive patients over a one-year period

Abstract

We evaluated daily self-monitored blood pressure (BP) data collected over one year using remote home monitoring. Fifty treated, moderately hypertensive subjects (26 males, mean age 50 years; 17 females, mean age 54 years; seven exclusions) were recruited for the study in which semi-automatic arm-cuff BP measurement devices were used. The daily self-monitoring regimen had two phases of usage: one of initial enthusiasm (the first one to two months) followed by a phase of lower usage (89% versus 64%, P<0.01). Monitoring was missed more often (P<0.01) during weekends (7.3 instances per patient) compared with workdays (5.0). Lack of motivation was not considered to be a major barrier. Approximately half of the study population was willing to continue the trial at the end of the one-year study. The occurrence of extreme BP values dropped significantly after the initial study month (P=0.02). In conclusion, routine remote BP monitoring is capable of collecting consistent and accurate data, with sufficient sensitivity to reveal trends.

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References

Imai

, Hozawa

, Ohkubo

Predictive values of automated blood pressure measurement: what can we learn from the Japanese population - the Ohasama study. Blood Press Monit 2001; 6: 335–9

Palatini

Too much of a good thing? A critique of overemphasis on the use of ambulatory blood pressure monitoring in clinical practice. J Hypertens 2002; 20: 1917–23

Chatellier

, Battaglia

, Pagny

, Plouin

, Menard

Decision to treat mild hypertension after assessment by ambulatory monitoring and World Health Organisation recommendations. Br Med J 1992; 305: 1062–6

Rudd

Compliance with antihypertensive therapy: raising the bar of expectations. Am J Manage Care 1998; 4: 957–66

Mar

, Pastor

, Abasolo

, Ruiz de Gauna

Ambulatory blood pressure monitoring and diagnostic errors in hypertension: a Bayesian approach. Med Decis Making 1998; 18: 429–35

The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413–46

Williams

, Poulter

, Brown

Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens 2004; 18: 139–85

Hagemeister

, Schneider

, Barabas

Hypertension guidelines and their limitations - the impact of physicians’ compliance as evaluated by guideline awareness. J Hypertens 2001; 19: 2079–86

Cuspidi

, Michev

, Meani

Awareness of hypertension guidelines in primary care: results of a regionwide survey in Italy. J Hum Hypertens 2003; 17: 541–7

10.

Pedone

, Lapane

KL.

Generalizability of guidelines and physicians’ adherence. Case study on the Sixth Joint National Committee's guidelines on hypertension. BMC Public Health 2003; 3: 24

11.

Benediktsson

, Padfield

PL.

Maximizing the benefit of treatment in mild hypertension: three simple steps to improve diagnostic accuracy. Q J Med 2004; 97: 15–20

12.

Selenta

, Hogan

, Linden

How often do office blood pressure measurements fail to identify true hypertension? An exploration of white-coat normotension. Arch Fam Med 2000; 9: 533–40

13.

Bobrie

, Genes

, Vaur

Is ‘isolated home’ hypertension as opposed to ‘isolated office’ hypertension a sign of greater cardiovascular risk?

Arch Intern Med 2001; 161: 2205–11

14.

Mancia

, Parati

The role of blood pressure variability in end-organ damage. J Hypertens 2003; 21: 17–23