Home Blood Pressure Monitoring
Home Blood Pressure Monitoring
A systematic review of the literature provides direction for the development of future policy guidelines related to HBPM and informs the potential effects on cost, quality, and patient endpoints in blood pressure control, as well as a patient partnership in the approach to care.
A review of research studies published over the past 5 years was conducted using Pub-Med, CINAHL, and OVID electronic search engines. Keywords were hypertension, home blood pressure monitoring, and interventions. Exclusion criteria included ongoing studies, ambulatory monitoring, adolescents, and pregnant patients. Abstract and full text articles were reviewed, and published studies that included HBPM as an effective method to contribute to hypertension control for adults were included.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to formulate evidence-based criteria for a systematic review of the current research regarding HBPM and implementation strategies. Levels of evidence are based on the John Hopkins Nursing Evidence Based Practice Research Evidence Appraisal.
The literature search produced 118 titles: 38 full text articles were reviewed, and 12 full text articles met the inclusion criteria. Exceptions to the time criterion were 2 studies, Cappuccio and Staessen, which were randomized controlled trials (RCTs) that are frequently cited in the literature. Summarized are 7 studies that supply the evidence for HBPM and 5 studies for home BP implementation strategies (Table 1). Six studies were level I RCTs or meta-analyses. Three studies were level II quasi-experimental, and 3 studies were level III nonexperimental or qualitative studies. The 7 studies for HBPM evidence were levels I, II, and III, and the 5 studies for HBPM interventions were levels I and II. Twelve studies included education as a vital component for reducing BP. Five studies included a team approach to implementing HBPM; in those studies, team members such as nurses conducted behavioral interventions that improved BP control. Five studies included self-management in HBPM that demonstrated a reduction in BP.
Findings of this systematic literature review support advanced practice nurses (APNs) using HBPM as part of usual care in primary care practices. Findings also support APNs recommending HBPM as a team-based behavioral intervention, in addition to providing patient education and self-management skills, incorporating practice guidelines, and implementing Wagner's Chronic Care Model to improve patient BP control.
Evidence
A systematic review of the literature provides direction for the development of future policy guidelines related to HBPM and informs the potential effects on cost, quality, and patient endpoints in blood pressure control, as well as a patient partnership in the approach to care.
A review of research studies published over the past 5 years was conducted using Pub-Med, CINAHL, and OVID electronic search engines. Keywords were hypertension, home blood pressure monitoring, and interventions. Exclusion criteria included ongoing studies, ambulatory monitoring, adolescents, and pregnant patients. Abstract and full text articles were reviewed, and published studies that included HBPM as an effective method to contribute to hypertension control for adults were included.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to formulate evidence-based criteria for a systematic review of the current research regarding HBPM and implementation strategies. Levels of evidence are based on the John Hopkins Nursing Evidence Based Practice Research Evidence Appraisal.
The literature search produced 118 titles: 38 full text articles were reviewed, and 12 full text articles met the inclusion criteria. Exceptions to the time criterion were 2 studies, Cappuccio and Staessen, which were randomized controlled trials (RCTs) that are frequently cited in the literature. Summarized are 7 studies that supply the evidence for HBPM and 5 studies for home BP implementation strategies (Table 1). Six studies were level I RCTs or meta-analyses. Three studies were level II quasi-experimental, and 3 studies were level III nonexperimental or qualitative studies. The 7 studies for HBPM evidence were levels I, II, and III, and the 5 studies for HBPM interventions were levels I and II. Twelve studies included education as a vital component for reducing BP. Five studies included a team approach to implementing HBPM; in those studies, team members such as nurses conducted behavioral interventions that improved BP control. Five studies included self-management in HBPM that demonstrated a reduction in BP.
Findings of this systematic literature review support advanced practice nurses (APNs) using HBPM as part of usual care in primary care practices. Findings also support APNs recommending HBPM as a team-based behavioral intervention, in addition to providing patient education and self-management skills, incorporating practice guidelines, and implementing Wagner's Chronic Care Model to improve patient BP control.
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