Unreliability of home blood pressure measurement and the effect of a patient-oriented intervention.
BACKGROUND
Home blood pressure (BP) measurement (HBPM) is recommended for the diagnosis and follow-up of high BP. It is unclear how this aspect of BP monitoring has evolved over the years and whether interventions could influence patient adherence to HBPM guidelines.


METHODS
After a questionnaire-based cross-sectional study performed in 2010, a passive, multimodal intervention, focused on improving adherence to HBPM guidelines, was implemented. A second study was conducted in 2014 to measure its effect.


RESULTS
In 2010 and 2014, 1010 and 1005 patients, respectively, completed the questionnaire. In 2010 and 2014, 82% and 84% of patients, respectively, self-measured their BP. Reporting of HBPM and adherence to recommended procedures was suboptimal. Only 34.0% of patients in 2010 and 31.7% in 2014 brought > 80% of their measurements to their doctor. Only 49.6% in 2010 and 52.9% in 2014 prepared > 80% of the time for HBPM. Only 48.1% in 2010 and 52.1% in 2014 rested for 5 minutes > 80% of the time before HBPM. Only 15% of patients in 2010 and 18% in 2014 were defined as sufficiently compliant with all HBPM procedures. Paired analysis of a subset of 535 patients who participated in the 2010 and 2014 studies showed no clinically significant differences in reliability between the 2 surveys.


CONCLUSIONS
Adherence to HBPM guidelines was suboptimal in 2010 and still is in 2014 despite a passive, multimodal intervention. Active training in HBPM procedures should be studied. Greater automation could improve HBPM reliability.
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada.
Jean-Philippe
JP
Milot
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada.
Leora
L
Birnbaum
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada.
Pierre
P
Larochelle
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada.
Robert
R
Wistaff
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada.
Mikhael
M
Laskine
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada.
Paul
P
Van Nguyen
Institut de recherches cliniques de Montréal (IRCM), Montreal, Quebec, Canada. Electronic address: lamarrm@ircm.qc.ca.
Maxime
M
Lamarre-Cliche
D000367:Age Factors; D000368:Aged; D001795:Blood Pressure Determination / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods; D011792:Quebec; D015203:Reproducibility of Results; D018570:Risk Assessment; D012648:Self Care / Q000592:standards* / Q000639:trends; D012680:Sensitivity and Specificity; D012737:Sex Factors; D011795:Surveys and Questionnaires