Skip to main content

Advertisement

SpringerLink
Log in

The Role of Home Blood Pressure Telemonitoring in Managing Hypertensive Populations

  • Hypertension and the Heart (PW de Leeuw and AH Gradman, Section Editors)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Hypertension is a common chronic disease affecting nearly one-third of the United States population. Many interventions have been designed to help patients manage their hypertension. With the evolving climate of healthcare, rapidly developing technology, and emphasis on delivering patient-centered care, home-based blood pressure telemonitoring is a promising tool to help patients achieve optimal blood pressure (BP) control. Home-based blood pressure telemonitoring is associated with reductions in blood pressure values and increased patient satisfaction. However, additional research is needed to understand cost-effectiveness and long-term clinical outcomes of home-based BP monitoring. We review key interventional trials involving home based BP monitoring, with special emphasis placed on studies involving additionally behavioral modification and/or medication management. Furthermore, we discuss the role of home-based blood pressure telemonitoring within the context of the patient-centered medical home and the evolving role of technology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Vital signs: prevalence, treatment, and control of hypertension--United States, 1999–2002 and 2005–2008. MMWR Morb Mortal Wkly Rep. 2011;60(4):103–8.

  2. Guo F, He D, Zhang W, Walton RG. Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010. J Am Coll Cardiol. 2012;60(7):599–606.

    Article  PubMed  Google Scholar 

  3. Patel B, Turban S, Anderson C, Charleston J, Miller ER, Appel LJ. A comparison of web sites used to manage and present home blood pressure readings. J Clin Hypertens (Greenwich, Conn). 2010;12(6):389–95.

    Article  Google Scholar 

  4. Fisher ES. Building a medical neighborhood for the medical home. N Engl J Med. 2008;359(12):1202–5.

    Article  PubMed  CAS  Google Scholar 

  5. Joint principles of the patient-centered medical home [http://www.medicalhomeinfo.org/JointStatement.pdf]

  6. Jackson GL, Powers BJ, Chatterjee R, Prvu Bettger J, Kemper AR, Hasselblad V, et al. The patient-centered medical home: a systematic review. Ann Intern Med. 2013;158(3):169–178.

    Google Scholar 

  7. Rosenthal TC. The medical home: growing evidence to support a new approach to primary care. J Am Board Family Med: JABFM. 2008;21(5):427–40.

    Article  PubMed  Google Scholar 

  8. Friedman RH, Kazis LE, Jette A, Smith MB, Stollerman J, Torgerson J, et al. A telecommunications system for monitoring and counseling patients with hypertension. Impact on medication adherence and blood pressure control. Am J Hypertens. 1996;9(4 Pt 1):285–92.

    Article  PubMed  CAS  Google Scholar 

  9. Pinto BM, Friedman R, Marcus BH, Kelley H, Tennstedt S, Gillman MW. Effects of a computer-based, telephone-counseling system on physical activity. Am J Prev Med. 2002;23(2):113–20.

    Article  PubMed  Google Scholar 

  10. Bosworth HB, Olsen MK, Gentry P, Orr M, Dudley T, McCant F, et al. Nurse administered telephone intervention for blood pressure control: a patient-tailored multifactorial intervention. Patient Educ Couns. 2005;57(1):5–14.

    Article  PubMed  Google Scholar 

  11. Friedman RH. Automated telephone conversations to assess health behavior and deliver behavioral interventions. J Med Syst. 1998;22(2):95–102.

    Article  PubMed  CAS  Google Scholar 

  12. Cottrell E, McMillan K, Chambers R. A cross-sectional survey and service evaluation of simple telehealth in primary care: what do patients think? BMJ Open. 2012;2(6):e001392. doi:10.1136/bmjopen-2012-001392.

  13. Datta SK, Oddone EZ, Olsen MK, Orr M, McCant F, Gentry P, et al. Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients. Am Hear J. 2010;160(2):257–63.

    Article  Google Scholar 

  14. Lovibond K, Jowett S, Barton P, Caulfield M, Heneghan C, Hobbs FD, et al. Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study. Lancet. 2011;378(9798):1219–30.

    Article  PubMed  Google Scholar 

  15. Madsen LB, Christiansen T, Kirkegaard P, Pedersen EB. Economic evaluation of home blood pressure telemonitoring: a randomized controlled trial. Blood Press. 2011;20(2):117–25.

    Article  PubMed  Google Scholar 

  16. Reed SD, Li Y, Oddone EZ, Neary AM, Orr MM, Grubber JM, et al. Economic evaluation of home blood pressure monitoring with or without telephonic behavioral self-management in patients with hypertension. Am J Hypertens. 2010;23(2):142–8.

    Article  PubMed  Google Scholar 

  17. Wang V, Smith VA, Bosworth HB, Oddone EZ, Olsen MK, McCant F, et al. Economic evaluation of telephone self-management interventions for blood pressure control. Am Hear J. 2012;163(6):980–6.

    Article  Google Scholar 

  18. Staessen JA, Thijs L, Fagard R, O’Brien ET, Clement D, de Leeuw PW, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA. 1999;282(6):539–46.

    Article  PubMed  CAS  Google Scholar 

  19. Turnbull SM, Magennis SP, Turnbull CJ. Patient self-monitoring of blood pressure in general practice: the ‘inverse white-coat’ response. British J G Prac: J Royal Coll Gen Pract. 2003;53(488):221–3.

    Google Scholar 

  20. Pickering T. White coat hypertension’–should it be treated or not? Cleve Clin J Med. 2002;69(8):584–5.

    Article  PubMed  Google Scholar 

  21. Powers BJ, Olsen MK, Smith VA, Woolson RF, Bosworth HB, Oddone EZ. Measuring blood pressure for decision making and quality reporting: where and how many measures? Ann Intern Med. 2011;154(12):781–8. W-289-790.

    Article  PubMed  Google Scholar 

  22. Bosworth HB, Olsen MK, Grubber JM, Neary AM, Orr MM, Powers BJ, et al. Two self-management interventions to improve hypertension control: a randomized trial. Ann Intern Med. 2009;151(10):687–95.

    Article  PubMed  Google Scholar 

  23. Chiu CW, Wong FK. Effects of 8 weeks sustained follow-up after a nurse consultation on hypertension: a randomised trial. Int J Nurs Stud. 2010;47(11):1374–82.

    Article  PubMed  Google Scholar 

  24. Hebert PL, Sisk JE, Tuzzio L, Casabianca JM, Pogue VA, Wang JJ, et al. Nurse-led disease management for hypertension control in a diverse urban community: a randomized trial. J Gen Intern Med. 2012;27(6):630–9.

    Article  PubMed  Google Scholar 

  25. Kerby TJ, Asche SE, Maciosek MV, O’Connor PJ, Sperl-Hillen JM, Margolis KL. Adherence to blood pressure telemonitoring in a cluster-randomized clinical trial. J Clin Hypertens (Greenwich, Conn). 2012;14(10):668–74.

    Article  Google Scholar 

  26. Kerry SM, Markus HS, Khong TK, Cloud GC, Tulloch J, Coster D, et al. Home blood pressure monitoring with nurse-led telephone support among patients with hypertension and a history of stroke: a community-based randomized controlled trial. CMAJ. 2013;185(1):23–31. doi:10.1503/cmaj.120832.

  27. Kim MT, Han HR, Hedlin H, Kim J, Song HJ, Kim KB, et al. Teletransmitted monitoring of blood pressure and bilingual nurse counseling-sustained improvements in blood pressure control during 12 months in hypertensive Korean Americans. J Clin Hypertens (Greenwich, Conn). 2011;13(8):605–12.

    Article  Google Scholar 

  28. Magid DJ, Ho PM, Olson KL, Brand DW, Welch LK, Snow KE, et al. A multimodal blood pressure control intervention in 3 healthcare systems. Am J Manag Care. 2011;17(4):e96–103.

    PubMed  Google Scholar 

  29. Melnyk SD, Zullig LL, McCant F, Danus S, Oddone E, Bastian L, Olsen M, Stechuchak KM, Edelman D, Rakley S et al. Telemedicine Cardiovascular Risk Reduction Intervention in Veterans. Am Heart J. 2013;165(4)501–8.

    Google Scholar 

  30. Wakefield BJ, Holman JE, Ray A, Scherubel M, Adams MR, Hills SL, et al. Outcomes of a home telehealth intervention for patients with diabetes and hypertension. Telemed J e-health: Off J Am Telemed Assoc. 2012;18(8):575–9.

    Article  Google Scholar 

  31. Carter BL, Bosworth HB, Green BB. The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. Journal of clinical hypertension (Greenwich, Conn). 2012, 14(1):51–65.

    Google Scholar 

  32. Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V, et al. Home blood pressure management and improved blood pressure control: results from a randomized controlled trial. Arch Intern Med. 2011;171(13):1173–80.

    Article  PubMed  Google Scholar 

  33. DeBusk RF, Houston Miller N, West JA. Diabetes case management. Ann Intern Med. 1999;130(10):863.

    Article  PubMed  CAS  Google Scholar 

  34. DeBusk RF, West JA, Miller NH, Taylor CB. Chronic disease management: treating the patient with disease(s) vs treating disease(s) in the patient. Arch Intern Med. 1999;159(22):2739–42.

    Article  PubMed  CAS  Google Scholar 

  35. Santschi V, Chiolero A, Burnand B, Colosimo AL, Paradis G. Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials. Arch Intern Med. 2011;171(16):1441–53.

    Article  PubMed  CAS  Google Scholar 

  36. Harris IM, Baker E, Berry TM, Halloran MA, Lindauer K, Ragucci KR, et al. Developing a Business-Practice Model for Pharmacy Services in Ambulatory Settings. Pharmacotherapy. 2008;28(2):7e–34e.

    Article  Google Scholar 

  37. Burke JM, Miller WA, Spencer AP, Crank CW, Adkins L, Certch KE, et al. Clinical Pharmacist Competencies. Pharmacotherapy. 2008;28(6):806–15.

    Article  PubMed  Google Scholar 

  38. Carter BL, Bergus GR, Dawson JD, Farris KB, Doucette WR, Chrischilles EA, Hartz AJ. A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control. Journal of clinical hypertension. (Greenwich, Conn) 2008, 10(4):260–271.

    Google Scholar 

  39. Gattis WA, Hasselblad V, Whellan DJ, O’Connor CM. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study. Arch Intern Med. 1999;159(16):1939–45.

    Article  PubMed  CAS  Google Scholar 

  40. McLean DL, McAlister FA, Johnson JA, King KM, Makowsky MJ, Jones CA, et al. A randomized trial of the effect of community pharmacist and nurse care on improving blood pressure management in patients with diabetes mellitus: study of cardiovascular risk intervention by pharmacists-hypertension (SCRIP-HTN). Arch Intern Med. 2008;168(21):2355–61.

    Article  PubMed  Google Scholar 

  41. Rothman RL, Malone R, Bryant B, Shintani AK, Crigler B, Dewalt DA, et al. A randomized trial of a primary care-based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes. Am J Med. 2005;118(3):276–84.

    Article  PubMed  Google Scholar 

  42. Taveira TH, Wu WC, Martin OJ, Schleinitz MD, Friedmann P, Sharma SC. Pharmacist-led cardiac risk reduction model. Prev Cardiol. 2006;9(4):202–8.

    Article  PubMed  Google Scholar 

  43. Tsuyuki RT, Johnson JA, Teo KK, Simpson SH, Ackman ML, Biggs RS, et al. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Arch Intern Med. 2002;162(10):1149–55.

    Article  PubMed  Google Scholar 

  44. van Dalem J, Krass I, Aslani P. Interventions promoting adherence to cardiovascular medicines. Int J Clin Pharm. 2012;34(2):295–311.

    Article  PubMed  Google Scholar 

  45. Logan AG, Irvine MJ, McIsaac WJ, Tisler A, Rossos PG, Easty A, et al. Effect of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics. Hypertension. 2012;60(1):51–7.

    Article  PubMed  CAS  Google Scholar 

  46. Resnick HE, Ilagan PR, Kaylor MB, Mehling D, Alwan M. TEAhM-Technologies for Enhancing Access to Health Management: a pilot study of community-based telehealth. Telemed J e-health: Off J Am Telemed Assoc. 2012;18(3):166–74.

    Article  Google Scholar 

  47. Tsuyuki RT, Houle SKD. 13 Opportunities to Improve Hypertension Care in the Community: An Analysis of Over 8 Million Pharmacy-Based Blood Pressure Kiosk Readings. Journal of Hypertension. 2012, 30(e1).

  48. Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, et al. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA: J Am Med Assoc. 2008;299(24):2857–67.

    Article  CAS  Google Scholar 

  49. Green BB, Ralston JD, Fishman PA, Catz SL, Cook A, Carlson J, et al. Electronic communications and home blood pressure monitoring (e-BP) study: design, delivery, and evaluation framework. Contemp Clin Trials. 2008;29(3):376–95.

    Article  PubMed  Google Scholar 

  50. Morikawa N, Yamasue K, Tochikubo O, Mizushima S. Effect of salt reduction intervention program using an electronic salt sensor and cellular phone on blood pressure among hypertensive workers. Clinical and experimental hypertension. (New York, NY : 1993) 2011, 33(4):216–222.

  51. Shaw RJ, Johnson CM. Health Information Seeking and Social Media Use on the Internet among People with Diabetes. Online journal of public health informatics. 2011, 3(1).

  52. Katz SJ, Moyer CA. The emerging role of online communication between patients and their providers. J Gen Intern Med. 2004;19(9):978–83.

    Article  PubMed  Google Scholar 

  53. McGeady D, Kujala J, Ilvonen K. The impact of patient-physician web messaging on healthcare service provision. Intern J Med Inform. 2008;77(1):17–23.

    Article  Google Scholar 

  54. Eysenbach G. What is e-health? J Med Internet Res. 2001;3(2):E20.

    Article  PubMed  CAS  Google Scholar 

  55. Green BB, Anderson ML, Ralston JD, Catz S, Fishman PA, Cook AJ. Patient ability and willingness to participate in a web-based intervention to improve hypertension control. J Med Internet Res. 2011;13(1):e1.

    Article  PubMed  Google Scholar 

  56. Adie K, James MA. Does telephone follow-up improve blood pressure after minor stroke or TIA? Age Ageing. 2010;39(5):598–603.

    Article  PubMed  Google Scholar 

  57. Shaw R, Bosworth HB. Baseline medication adherence and blood pressure in a 24-month longitudinal hypertension study. J Clin Nurs. 2012;21(9–10):1401–6.

    Article  PubMed  Google Scholar 

  58. Bodenheimer T, Pham HH. Primary care: current problems and proposed solutions. Health Aff (Project Hope). 2010;29(5):799–805.

    Article  Google Scholar 

Download references

Acknowledgments

Dr. Zullig is supported by funding from the National Cancer Institute (5R25CA116339). Dr. Bosworth was supported by a research career scientist award from the VA Health Service Research and Development (VA HSR&D 08–027). Dr. Shaw was supported by Health Services Research and Development Service, Department of Veterans Affairs, Office of Academic Affiliations (TPP-21-021). The content is solely the responsibility of the authors and does not necessarily represent the views US Department of Veterans Affairs.

Conflict of Interest

L.L. Zullig declares that she has no conflict of interest.

S.D. Melnyk declares that she has no conflict of interest.

K. Goldstein declares that she has no conflict of interest.

R.J. Shaw declares that he has no conflict of interest.

H.B. Bosworth declares that he has no conflict of interest.

Author information

Authors and Affiliations

  1. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 411 West Chapel Street, Durham, NC, 27701, USA

    Leah L. Zullig, S. Dee Melnyk, Karen Goldstein, Ryan J. Shaw & Hayden B. Bosworth

  2. Department of Health Policy and Management, University of North Carolina, 1101 McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC, 27599, USA

    Leah L. Zullig

  3. University of North Carolina Eshelman School of Pharmacy, CB #7355, Chapel Hill, NC, 27599, USA

    S. Dee Melnyk

  4. Ambulatory Care Services, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA

    S. Dee Melnyk & Karen Goldstein

  5. Division of General Internal Medicine, Duke University, 2301 Erwin Road, Durham, NC, 27710, USA

    Karen Goldstein & Hayden B. Bosworth

  6. Departments of Psychiatry and School of Nursing, Duke University, 2301 Erwin Road, Durham, NC, 27710, USA

    Hayden B. Bosworth

Authors
  1. Leah L. Zullig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Dee Melnyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen Goldstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ryan J. Shaw
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hayden B. Bosworth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leah L. Zullig.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zullig, L.L., Dee Melnyk, S., Goldstein, K. et al. The Role of Home Blood Pressure Telemonitoring in Managing Hypertensive Populations. Curr Hypertens Rep 15, 346–355 (2013). https://doi.org/10.1007/s11906-013-0351-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-013-0351-6

Keywords

Search

Navigation