L008: Physician and patient attitudes towards self-monitoring of blood pressure (SMBP) before and after SMBP use

• Published in: American journal of hypertension 2000-04, Vol.13 (S2), p.297A-297A
• Main Authors: Cheng, C., Studdiford, J.S., Diamond, J.J., Sen, S., Chambers, C.V., Trapani, L, Perkel, R.L.
• Format: Article
• Language: English
• Subjects: attitudes; Home blood pressure monitor; patients; physicians
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1016/S0895-7061(00)01075-X

Patient self-monitoring of blood pressure (SMBP) may result in improved identification and control of hypertension. In several studies, ambulatory blood pressure monitoring (ABPM) and SMBP measurements are better correlated with the presence of left ventricular hypertrophy and other hypertensive target organ damage than office BP measurements. However, most studies of SMBP to date have been conducted in subspecialty clinics. Acceptance of SMBP by patients and physicians in primary care practices is unstudied. In other chronic diseases like diabetes and asthma, factors such as patient health beliefs and good patient-physician communication are the best predictors of patient compliance with self-monitoring interventions. We hypothesized that benefits of SMBP would be greater in patients with health beliefs of “active involvement” in medical decision-making and recognition of the “serious” risks of hypertension. We designed a randomized controlled trial to: 1) measure changes in physician-patient attitudes towards SMBP following an intervention of SMBP monitor use, and 2) determine the factors most important in predicting effectiveness, compliance, and satisfaction with the SMBP intervention in physicians and patients. We assessed patient and physician attitudes and beliefs before and after six months of SMBP. Secondary outcomes included BP measurements and health care utilization. One hundred patients (from 25 primary care providers) will be randomized by January 2000. Results from completed patient and physician surveys will be presented and a model for predicting which patients will benefit from SMBP will be proposed.