Success With a Home BP Monitoring Program in Colorado
Success With a Home BP Monitoring Program in Colorado
A CARE enrolled a total of 3578 participants from January 2007 to June 2010. Demographic characteristics of these patients are shown in Table 1. Of these patients, 24% had self-identified diabetes mellitus. Approximately 10% of patients used the wrist cuff.
Active participants in A CARE were those who submitted at least 2 home blood pressure reports; 36% of A CARE participants were active participants (see Table 2). Over an average of 368 days of participation, active participants submitted a mean of 13.5 average home blood pressure reports, with a mean of 19.3 readings per report. The average time between submitted reports was 56.9 days. Initial home blood pressure (systolic/diastolic) for active participants was 137.6/83.0 mmHg. This decreased to 131.2/78.7 mmHg on the final home blood pressure report, for a mean difference of −6.5/−4.4 mmHg (P < .001). The percentage of these patients achieving target blood pressures increased from 34.5% initially to 53.3% on the final home blood pressure report (P < .001). For participants with diabetes, the mean difference in home blood pressure was −6.7/−4.7 mmHg (P < .001), and the percentage of patients at target increased from 24.6% initially to 40.0% (P < .001).
A chart audit compared office blood pressures of 378 randomly selected patients who had participated in A CARE for at least 4 months with office blood pressures of 352 randomly selected control nonparticipants. There was no significant difference in age or diabetes status between the 2 groups. The A CARE participant group had a larger percentage of Hispanic patients than the group of nonparticipants (see Table 3).
For A CARE participants, mean office blood pressure decreased 6.3/4.1 mmHg, from 141.5/84.4 to 135.1/80.4 mmHg (P < .001). The change in mean systolic and diastolic blood pressure in the office for nonparticipants was not significant (see Table 4). The mean difference between the A CARE patients and nonparticipants was −5.4/−2.7 mmHg (P < .001 for systolic blood pressure; P = .01 for diastolic blood pressure). For A CARE patients with diabetes, mean office blood pressure decreased from 142.3/8.0 to 137.0/79.3 mmHg (see Table 4 and Table 5). There was no significant change in mean office blood pressure for nonparticipants with diabetes. Among patients with diabetes, the mean difference between the groups was −8.5/−1.5 (P = .014 for systolic blood pressure; P = .405 for diastolic blood pressure).
There was a 56.8% increase in the percentage of patients with an at-target office blood pressure in the A CARE program, compared with a 18.8% increase in the control group (P = .078; see Table 5).
Results
A CARE enrolled a total of 3578 participants from January 2007 to June 2010. Demographic characteristics of these patients are shown in Table 1. Of these patients, 24% had self-identified diabetes mellitus. Approximately 10% of patients used the wrist cuff.
Home Blood Pressure Monitoring
Active participants in A CARE were those who submitted at least 2 home blood pressure reports; 36% of A CARE participants were active participants (see Table 2). Over an average of 368 days of participation, active participants submitted a mean of 13.5 average home blood pressure reports, with a mean of 19.3 readings per report. The average time between submitted reports was 56.9 days. Initial home blood pressure (systolic/diastolic) for active participants was 137.6/83.0 mmHg. This decreased to 131.2/78.7 mmHg on the final home blood pressure report, for a mean difference of −6.5/−4.4 mmHg (P < .001). The percentage of these patients achieving target blood pressures increased from 34.5% initially to 53.3% on the final home blood pressure report (P < .001). For participants with diabetes, the mean difference in home blood pressure was −6.7/−4.7 mmHg (P < .001), and the percentage of patients at target increased from 24.6% initially to 40.0% (P < .001).
Chart Audit
A chart audit compared office blood pressures of 378 randomly selected patients who had participated in A CARE for at least 4 months with office blood pressures of 352 randomly selected control nonparticipants. There was no significant difference in age or diabetes status between the 2 groups. The A CARE participant group had a larger percentage of Hispanic patients than the group of nonparticipants (see Table 3).
For A CARE participants, mean office blood pressure decreased 6.3/4.1 mmHg, from 141.5/84.4 to 135.1/80.4 mmHg (P < .001). The change in mean systolic and diastolic blood pressure in the office for nonparticipants was not significant (see Table 4). The mean difference between the A CARE patients and nonparticipants was −5.4/−2.7 mmHg (P < .001 for systolic blood pressure; P = .01 for diastolic blood pressure). For A CARE patients with diabetes, mean office blood pressure decreased from 142.3/8.0 to 137.0/79.3 mmHg (see Table 4 and Table 5). There was no significant change in mean office blood pressure for nonparticipants with diabetes. Among patients with diabetes, the mean difference between the groups was −8.5/−1.5 (P = .014 for systolic blood pressure; P = .405 for diastolic blood pressure).
There was a 56.8% increase in the percentage of patients with an at-target office blood pressure in the A CARE program, compared with a 18.8% increase in the control group (P = .078; see Table 5).
