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Blood pressure monitoring is better at home

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4293 (Published 09 September 2013) Cite this as: BMJ 2013;347:f4293

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A new trial from the US has confirmed that blood pressure is easier to control when monitoring is done from home and treatment decisions are made over the telephone—in this instance by a prescribing pharmacist. It’s time to redesign care so that patients no longer need to trek to a clinic for their monitoring and treatment, says a linked editorial (p 40). We now have good evidence from several trials that blood pressure control, like banking, works better when people do it at home.

The new trial tested a telemonitoring intervention that transmitted home based measurements to a pharmacist attached to a primary care practice. Pharmacist and patient had regular telephone conversations about lifestyles and adherence, and pharmacists changed treatments as needed. Controls attended clinics for monitoring, advice, and treatment as usual. The 450 participants started the trial with poorly controlled blood pressure. Most were overweight or obese and a fifth had diabetes.

Compared with controls, a greater proportion of patients managed at home had well controlled blood pressure at both six months and 12 months (57.2% v 30.0%; P<0.001). Their blood pressure fell further and the difference in control persisted for at least six months after the intervention came to an end. Patients managed at home had more intensive treatment and took it with greater fidelity than controls. The intervention had little impact on lifestyle.

Notes

Cite this as: BMJ 2013;347:f4293

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