Home blood pressure measurements are not performed according to guidelines and standardized education is urgently needed

Abstract

Background: Home blood pressure measurement (HBPM) utilizes digital health technologies for BP measurement, recording, reporting and monitoring. Patients need education to perform HBPM properly. It is unknown how HBPM is performed and what education is provided, which was the aim of the study.   Methods: Mixed-methods study among Australian adults who perform HBPM (June-Dec 2023). Participants completed a 30-item online survey on the guideline recommendations followed and education received for HBPM. Phone interviews were conducted among a purposive sample to explore survey topics.   Results: Participants (n=350) were middle-aged (58¬±16 years, 54% women) and most (n=250, 71%) had hypertension. One-third (n=118, 34%) of participants used a validated BP device for HBPM. Most purchased their device from a pharmacy (n=130, 69%) or online (n=39, 21%), using online reviews and brand recognition to select a device. When measuring BP, guideline recommendations for HBPM were not always followed by participants. Most participants measured BP seated (n=316, 90%) with the cuff fitted to a bare arm (n=269, 77%). Only 15% measured BP in the morning and evening (n=54). Almost all (n=277, 93%) participants sought information about HBPM; mostly from a GP (n=169, 61%) or online (n=165, 60%). Interview participants preferred trustworthy websites from well-known organizations and avoided international sites. Participants who sought information online did not perform higher quality HBPM.   Conclusions: HBPM is not performed according to guideline recommendations. Adults seek information about HBPM online, however this did not improve the quality of HBPM. These findings highlight a need for effective education to support HBPM.