Adoption of self-measured blood pressure monitoring in underserved communities: Program evaluation in primary care

Maureen Shields; Iridian Guzman; Jackie Rouse; Alvia Siddiqi; Mark J Pletcher; Rasha Khatib

doi:10.1111/jep.14130

Adoption of self-measured blood pressure monitoring in underserved communities: Program evaluation in primary care

J Eval Clin Pract. 2024 Aug 18. doi: 10.1111/jep.14130. Online ahead of print.

Authors

Maureen Shields¹, Iridian Guzman¹, Jackie Rouse², Alvia Siddiqi², Mark J Pletcher³, Rasha Khatib¹

Affiliations

¹ Advocate Aurora Research Institute, Milwaukee, Wisconsin, USA.
² Advocate Health, Milwaukee, Wisconsin, USA.
³ Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.

PMID: 39155625
DOI: 10.1111/jep.14130

Abstract

Rationale: Self-measured blood pressure (SMBP) monitoring is crucial for hypertension management, yet its adoption, particularly among disadvantaged populations, remains low. 'Love Your Heart' is a quality improvement program providing free standard SMBP devices to hypertensive patients, aiming to enhance adoption and assess its impact on blood pressure control.

Aims and objectives: This study evaluates the 'Love Your Heart' program's implementation success through assessing adoption rates and exploring changes in systolic blood pressure (SBP) among participants. We aim to understand factors influencing adoption and potential benefits of SMBP monitoring in a diverse, socially disadvantaged patient population.

Methods: We retrospectively evaluated the 'Love Your Heart' program using electronic health records (EHR) at a primary care site in Chicago. Adult patients with hypertension were enroled in the 6-month program, which included education sessions and free SMBP devices. Adoption was measured by participation in program components, and changes in SBP were analysed based on adoption status. Statistical analyses were conducted using SAS software, adhering to STROBE reporting guidelines.

Results: Of 621 eligible patients, 104 participated, with 83 included in the evaluation. Despite all participants receiving free SMBP devices, adoption rates were modest, with only 7% sharing readings with the care team. However, patients who received device instructions demonstrated greater decreases in SBP compared to those who did not. Although not statistically significant, clinically meaningful decreases in SBP were observed among adopters.

Conclusion: The 'Love Your Heart' program highlights the challenges of promoting SMBP monitoring among disadvantaged patient populations. While providing free devices addresses access barriers, low reporting to the care team suggests the need for further support mechanisms. Future research should explore strategies to enhance SMBP adoption and integration into clinical care, particularly in settings lacking automated data transmission systems.

Keywords: evaluation; healthcare; primary care.