Implementing a Self-measured Blood Pressure Monitoring Process

Practice Problem: Because of the prevalence of hypertension worldwide, it is prudent for all patients to have the knowledge and ability to self-monitor their blood pressure. Patients monitoring their own blood pressure and communicating the readings with healthcare providers facilitates a more comprehensive plan of care. PICOT: The PICOT question that guided this project was: In adults 18-90 years old with primary hypertension (P), will a self-measured blood pressure monitoring that includes a monthly telehealth visit with a provider (I), compared to blood pressure monitoring at routine office visits (C), decrease patients' systolic blood pressure readings by five mmHg (O) within 8 weeks (T)? Evidence: Research shows that self-measured blood pressure monitoring reduces blood pressure, possibly because treatment adherence is improved due to daily monitoring and reporting the reading to a provider. Intervention: Twenty participants took their blood pressure at home with a verified monitor and entered the readings into the patient portal for the provider to review for 8 weeks. Pre and post-project blood pressure readings were analyzed for home monitoring effectiveness. Outcome: A two-tailed paired samples t-test was used to show that the mean of the pre-project systolic blood pressure was significantly higher (143.60 mmHg) than the mean of the post-project systolic blood pressure (130.50 mmHg). Clinical significance was observed by lower systolic blood pressure readings of the hypertensive participants by the end of the project. Conclusion: By monitoring at home daily, the patient is aware of their blood pressure readings and understands when treatment changes are necessary. This increases patient engagement in the self-care of hypertension while reducing their blood pressure.