Effectiveness of Home Blood Pressure Monitoring Among Low-Income Adults in Rural Appalachia.
BACKGROUND
High blood pressure (BP) is a common chronic condition in the United States. For many people, BP control through pharmacologic intervention alone is not effective at maintaining a healthy BP. Team-based, patient-focused care and home-based BP monitoring in addition to pharmacologic interventions have been shown to be effective for controlling BP.


OBJECTIVE
To determine the effectiveness of the hypertension management program at the Heritage Community Clinic in Athens, Ohio.


METHODS
Medical records of 43 patients who took part in the hypertension management program were retrospectively reviewed and included clinical data such as age, sex, BP, body mass index, comorbidities, family history, and demographic information. In addition to standard pharmacologic interventions, the program provided equipment for at-home BP monitoring, education on behavior and lifestyle modification, and 5 follow-up visits. Data from the 5 follow-up visits were analyzed.


RESULTS
Linear mixed-effects regression models of BP suggested that the visit factor was significantly associated with BP (P<.001). On average at each visit, patients showed a 6.8-mm Hg reduction in systolic BP and a 3.8-mm Hg reduction in diastolic BP after controlling for demographic variables. General stress level, marital status, and depression were all significantly associated with BP (P<.05). In addition, 67.5% of the patients who took part in this program achieved the target treatment guidelines of the Eighth Joint National Committee for hypertension management.


CONCLUSIONS
A clinic-based hypertension management program comprising patient education, support, medication, and home BP monitoring was effective at reducing BP.
Joshua
J
Scakacs
Ian
I
Ackers
Jason
J
Rodriguez
Oben
O
Ojong-Egbe
Sharon
S
Casapulla
D001061:Appalachian Region; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006701:Home Nursing; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010353:Patient Education as Topic; D012189:Retrospective Studies; D012424:Rural Population; D012648:Self Care