title: Home blood-pressure monitoring among hypertensive patients in an Asian population.
abstract: Hypertension is a principal cause of mortality and morbidity in Singapore. The use of home blood-pressure monitoring (HBPM) to assess hypertensive control with digital devices in the local multi-racial population is unknown. The study determined the factors associated with hypertensive patients' use of HBPM in primary care in a multi-racial Asian population. Randomized cross-sectional questionnaire survey of hypertensive patients managed in a district polyclinic. A model predicting use of HBPM was constructed by univariate and multivariate logistic regression. A total of 224 eligible subjects were randomly selected from 1943 patients. Response rate was 78.1% (n = 175). In all, 61.7% of them were aware of HBPM but only 24% used HBPM. Using multivariate analysis by stepwise backward regression, the final fitted model showed that HBPM was associated with higher patients' socioeconomic status: (adjusted OR for middle-income status = 2.85, 95% CI: 1.2-6.78, P = 0.018; adjusted OR for high-income status = 3.46, 95% CI: 1.22-9.87, P = 0.020) and their documented diastolic BP (adjusted OR for diastolic BP > 80 mmHg = 2.26, 95% CI: 1.06-4.82, P = 0.034). Nonusers cited failure to recognize benefits (54.1%), lack of HBPM awareness (29.3%), understanding of device operation (18.8%) and perception of inaccuracy (10.5%) as deterrents. 76.2% of users were satisfied with HBPM but lacked knowledge in maintenance of devices. In conclusion, 61.7% of the study population were aware of HBPM but only 24% used it. Patients' failure to recognize benefits, lack of awareness, cost and perception of inaccuracy were barriers. Higher socioeconomic status and patient's documented diastolic BP correlated with HBPM usage.
authors.affiliation: SingHealth Polyclinics, Singapore. Tan.Ngiap.Chuan@singhealth.com.sg
authors.forename: N C
authors.initials: NC
authors.lastname: Tan
authors.forename: L W
authors.initials: LW
authors.lastname: Khin
authors.forename: R
authors.initials: R
authors.lastname: Pagi
mesh_terms: D000328:Adult; D044466:Asian People; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D015995:Prevalence; D012846:Singapore / Q000208:ethnology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires