Blood pressure monitoring Reviews 2013

Hypertension is an important public health issue. Self Measured Blood Pressure Monitoring (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control.

Purpose:

Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an explicit a stakeholder-driven nomination and prioritization process.

Methods:

Building on evidence gaps identified in a previous CER on SMBP, a preliminary list of future research needs (FRN) was supplemented and refined through input from stakeholders. Stakeholders were asked to indicate their top five priority topics considering the following dimensions in prioritization: (1) importance, (2) desirability of research/avoidance of unnecessary duplication, (3) feasibility, and (4) potential impact. The five topics with the highest number of stakeholder endorsements were identified as the prioritized FRN topics.

Future Research Needs Topics:

Four priority topics pertain to interrelated evidence gaps such as the lack of longer term studies which show persistence of BP control or clinical benefit from SMBP, uncertainty regarding who is likely to benefit from SMBP, lack of standardization in prescription of SMBP, and uncertainty regarding the most effective additional support. The fifth topic relates to the inability to assess cost-effectiveness of SMBP, due to the deficiencies in evidence identified in the first four gaps.

To address these gaps, longer term randomized controlled trials are needed to examine clinical outcomes; exploration of treatment heterogeneity may identify those groups more likely to benefit from SMPB. Different prescriptions of SMBP should be compared in trials examining SMBP adherence and BP control. Additional support that shows promise for future study should be further refined by expert panels. Filling these evidence gaps will inform future modeling of cost-effectiveness.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Contract No. 290-2007-10055-I. Prepared by: Tuft Evidence-based Practice Center, Tufts Medical Center, Boston, MA

Suggested citation:

Uhlig K, Patel K, Concannon TW, Balk EM, Ratichek SJ, Kong Win Chang L, Iovin R. Self-Measured Blood Pressure: Future Research Needs. Future Research Needs Paper No. 16. (Prepared by Tufts Evidence-based Practice Center under Contract No. 290-2007-10055-I.) Rockville, MD: AHRQ Publication No. 12-EHC088-EF. Rockville, MD: Agency for Healthcare Research and Quality. August 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Tufts Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10055-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.