Appropriateness of online resources for home blood pressure measurement: alignment with guideline recommendations, readability, and end-user involvement

Abstract

Background: Home blood pressure measurement (HBPM) utilizes digital health technologies and is most effective at BP control when delivered with patient education. Patient education should provide information that aligns with guidelines, meets a grade eight reading level, and involves end-users in development. It is unknown if online HBPM resources are appropriate for patient education. Using these criteria, this study aimed to determine the appropriateness of online HBPM resources.   Methods: Online HBPM resources were identified via environmental scan on Google (October 2022) using seven search terms developed with consumers (n=6). Resources were included if in English and not paywalled. Resource appropriateness was appraised by alignment with 23 HBPM recommendations from six guidelines, grade reading level as calculated by health literacy assessment software, and evidence of end-user involvement in development.   Results: Twenty-four HBPM resources were included. None of the resources aligned with all 23 guideline recommendations. Thirteen (54%) resources aligned with less than half (11/23) of the 23 guideline recommendations. All resources included the recommendation to measure BP when seated, while few stated to use a validated BP device (n=9, 38%). Half (12, 50%) the resources incorrectly stated the recommendation to take two BP readings one minute apart. All resources exceeded the recommended grade-eight reading level (mean 11.8, range 8.8-17.0) and none reported patient end-user involvement in development.   Conclusions: None of the online HBPM resources met all criteria to appropriately educate adults for HBPM. To support high-quality HBPM, resources should be developed with end-users using health literacy tools and multi-modal communication methods.