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Validity of home blood pressure measurements manually registered by patients after an educational session provided by
José Sendra-Lillo1, Fernando Martínez-Martínez, José Pedro García-Corpas
1aAcademic Centre in Pharmaceutical Care, University of Granada, Granada bCommunity Pharmacist in Beniel, Murcia, Spain cGraduate School of Health (UTS: Pharmacy), University of Technology, Sydney, Australia.
Insights
Community pharmacists
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Home blood pressure (HBP) monitoring is crucial for managing hypertension.
- Reliability of manually recorded HBP readings can be enhanced by professional guidance.
- Accurate HBP data is vital for effective clinical decision-making.
Purpose of the Study:
- To assess the agreement between patient-manually registered HBP and device-stored HBP.
- To evaluate the impact of community pharmacist educational interventions on HBP recording accuracy.
- To determine the concordance of HBP measurements after standardized patient instruction.
Main Methods:
- Utilized secondary data from MEPAFAR and Palmera studies.
- Included treated hypertensive patients receiving individual educational sessions from community pharmacists.
- Employed a 4-day HBP monitoring protocol (morning/evening) with manual registration and device storage.
- Analyzed agreement using Lin's correlation-concordance coefficient and kappa (κ) coefficient.
Main Results:
- Very good agreement observed between average manual and stored HBP readings (systolic: 0.99, diastolic: 0.99).
- High concordance in patient classification: 99.4% categorized identically by both methods (κ=0.99).
- Excellent quantitative and qualitative agreement found in HBP measurements.
Conclusions:
- Manual HBP registration by patients shows very good agreement with device-stored data.
- Community pharmacist educational interventions significantly enhance the reliability of manual HBP recordings.
- Accurate manual HBP data collection is feasible and reliable following pharmacist guidance.
Abstract:
When home blood pressure (HBP) measurements are taken, the readings can be registered manually by the patient and/or stored in the device's memory. The instructions provided by healthcare professionals would be particularly relevant to guarantee the reliability of manual blood pressure (BP) figures and enhance clinical decision making. The aim of this study is assess the agreement between HBP measurements manually registered by patients and those stored in the device's memory after an educational session provided by community pharmacists. Secondary data of the MEPAFAR and the Palmera studies have been used in this analysis. All the (treated hypertensive) patients attended an individual educational session in which they were instructed on how to use the measurement device and properly measure and manually register HBP. The same device and HBP monitoring protocol were used in both studies: 4 consecutive days (three morning measurements and three in the evening). HBP measurements were both manually registered by patients and stored in the device's memory. To evaluate the agreement between BP figures, Lin's correlation-concordance coefficient and κ coefficient were used for quantitative and qualitative agreement, respectively. One hundred and sixty-sixty patients were included in this analysis. The agreement between the average manual and the stored HBP was very good [systolic=0.99, 95% confidence interval (CI): 0.99-0.99; diastolic=0.99, 95% CI: 0.99-1.00]. 99.4% of patients were classified in the same category by both alternatives [κ index=0.99 (95% CI: 0.98-1.00)]. In this sample of treated hypertensive patients, the agreement between manually registered and stored BP figures was very good. This high concordance may be explained by the pharmacist's intervention.
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