Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2019 Jan;56(1):e13-e21. doi: 10.1016/j.amepre.2018.06.017. Epub 2018 Oct 15.
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.
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.
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).
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.
自我血压监测（SMBP）加额外的临床支持是一种基于证据的策略，可以改善血压控制。尽管美国有使用 SMBP 的国家建议，并且可能节省成本，但实施 SMBP 的保险范围有限，对临床实施的了解甚少。
2017 年，使用来自美国门诊设施的 1590 名初级保健医生和护士从业者的 2015 年和 2016 年 DocStyles 调查数据，评估了 SMBP 相关的临床实践和提供者角色。
几乎所有（97%）受访者报告使用 SMBP。在 1539 名使用 SMBP 的受访者中，超过一半（60%）将 SMBP 用于诊断和治疗目的的组合，而 24%仅将 SMBP 用于诊断，16%仅将 SMBP 用于治疗。患者与临床工作人员共享 SMBP 结果的最常见方法是纸质记录（68%）；在预约期间（66%）；通过电话（37%）；通过安全网站（22%）；或通过安全电子邮件（19%）。几乎所有（98%）受访者报告根据 SMBP 读数向患者提供药物调整。约 15%的受访者不向患者提供袖带尺寸的咨询，8%的受访者不验证患者的设备。只有 13%的受访者报告有监测器出借计划，并且可用性不受患者人群经济状况的影响（p=0.59）。
正如调查所报告的那样，SMBP 在门诊设施中广泛使用，尽管提供者角色和 SMBP 相关实践存在差异，并且在患者咨询、设备验证和出借计划可用性方面存在差距。作为改善高血压控制努力的一部分，医疗保健专业人员可以促进 SMBP 最佳实践的更多使用，而保险公司可以实施 SMBP 的标准化和支持。
