Abstract
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.
Résumé
Introduction
La mesure de la pression artérielle (PA) à domicile (MPAD) est recommandée pour le
diagnostic et le suivi de la PA élevée. On ignore de quelle manière cet aspect de
la surveillance de la PA a évolué au cours des années et si les interventions pourraient
influencer l’observance des lignes directrices de la MPAD par les patients.
Méthodes
Après une étude transversale basée sur un questionnaire réalisée en 2010, une intervention
multimodale passive mettant l’accent sur l’amélioration de l’observance des lignes
directrices en matière de MPAD a été mise en place. Une seconde étude a été menée
en 2014 pour mesurer ses effets.
Résultats
En 2010 et en 2014, 1010 et 1005 patients, respectivement, ont rempli le questionnaire.
En 2010 et en 2014, 82 % et 84 % des patients, respectivement, ont mesuré par eux-mêmes
leur PA. Le rapport de la MPAD et de l’observance des procédures recommandées était
sous-optimal. Seuls 34,0 % des patients en 2010 et 31,7 % des patients en 2014 ont
apporté > 80 % de leurs mesures à leur médecin. Seuls 49,6 % des patients en 2010
et 52,9 % en 2014 se sont préparés > 80 % du temps à la MPAD. Seuls 48,1 % des patients
en 2010 et 52,1 % en 2014 se sont reposés durant 5 minutes > 80 % du temps avant la
MPAD. Seuls 15 % des patients en 2010 et 18 % en 2014 ont été définis comme étant
des patients qui se conformaient suffisamment à toutes les procédures de la MPAD.
Les analyses appariées d’un sous-ensemble de 535 patients qui participaient aux études
de 2010 et de 2014 n’ont montré aucune différence cliniquement significative dans
la fiabilité entre les 2 enquêtes.
Conclusions
L’observance des lignes directrices en matière de MPAD qui était sous-optimale en
2010 l’a encore été en 2014 en dépit d’une intervention multimodale passive. Une formation
active sur les procédures de la MPAD devrait être étudiée. Une plus grande automatisation
pourrait améliorer la fiabilité de la MPAD.
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Article info
Publication history
Published online: March 11, 2015
Accepted:
March 9,
2015
Received:
February 19,
2015
Footnotes
See editorial by Myers, pages 583-584 of this issue.
See page 662 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
