title: What keeps patients from adhering to a home blood pressure program?
abstract: BACKGROUND
  Home blood pressure monitoring (HBPM) predicts cardiovascular risk and increases hypertension control. Non-participation in HBPM is prevalent and decreases the potential benefit.
  
  
  METHODS
  Telephone surveys were conducted with a random quota sample of non-participants in a HBPM program, which supplied a complimentary automated blood pressure cuff and utilized a centralized reporting system. Questioning assessed use of monitors, perceived benefit, communication with providers, and barriers.
  
  
  RESULTS
  There were 320 completed surveys (response rate 53%). Of non-participants, 70.2% still used HBPM cuffs and 58% communicated values to providers. Spanish-speakers were 4.4 times more likely to not use cuffs (95% CI, 2.22-8.885). Barriers to participation were largely personal (forgetting, not having time, or self-described laziness). Reasons for not communicating readings with providers were largely clinic factors (no doctor visit, doctor didn't ask, thinking doctor wouldn't care). Lack of knowledge of HBPM and program design also contributed. After being surveyed, patients were over three times more likely to use the central reporting system.
  
  
  CONCLUSIONS
  Most non-participants still used HBPM and communicated values to providers, suggesting many "drop-outs" may still receive clinical benefit. However, much valuable information is not utilized. Future programs should focus on reminder systems, patient motivation, education, and minimizing time involvement.
authors: Department of Family Medicine, University of Colorado, Denver, CO 80220, USA. LJSturgess@gmail.com
authors: Laura S
authors: LS
authors: Huff
authors: Linda
authors: L
authors: Zittleman
authors: Lauren
authors: L
authors: DeAlleaume
authors: Jackie
authors: J
authors: Bernstein
authors: Robert
authors: R
authors: Chavez
authors: Christin
authors: C
authors: Sutte
authors: William G
authors: WG
authors: LeBlanc
authors: Bennett
authors: B
authors: Parnes
mesh_terms: D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D003120:Colorado; D003144:Communication Barriers; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D013997:Time Factors