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Feasibility of home blood pressure screening in the paediatric outpatient clinic setting
Jessie R Mackay1,2, Jonathan P Glenning3,2,4, Brittany M Grantham1,2
1Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Insights
Home blood pressure (BP) screening is a feasible and acceptable method for children at high risk of hypertension. This approach offers comparable results to clinic measurements, reduces anxiety, and is preferred by families, potentially lowering healthcare costs.
Area of Science:
- Pediatric Cardiology
- Hypertension Research
- Health Services Research
Background:
- Children with neurofibromatosis type 1 (NF1) have an elevated risk of developing hypertension.
- Traditional clinic-based blood pressure (BP) monitoring can be burdensome for pediatric patients and their families.
Purpose of the Study:
- To evaluate the acceptability and feasibility of home-based BP screening in pediatric patients at high risk for hypertension.
- To compare home BP measurements with clinic-based measurements in this population.
Main Methods:
- A cross-sectional study involving 52 children and adolescents with NF1.
- Home BP was measured daily for 3 days using an automated device, alongside clinic BP measurements (manual and automated).
- Acceptability and feasibility were assessed via anxiety scores, BP comparability, parental surveys, cost analysis, and device return rates.
Main Results:
- Home BP measurements were statistically similar to both manual and automated clinic BP readings.
- Anxiety scores were comparable between home and clinic settings.
- Families found home BP screening easy, time-efficient, minimally disruptive, and largely preferred it over clinic visits, with a 90% device return rate.
Conclusions:
- Home-based BP screening is an acceptable and feasible alternative for pediatric patients at risk of hypertension.
- This method provides comparable BP data to clinic measurements without increasing anxiety.
- Home BP screening, integrated with telehealth, can reduce patient costs, improve care equity, and enhance access to health services.
Objective:
The aim of this study was to evaluate the acceptability and feasibility of home-based blood pressure (BP) screening in a group of paediatric patients with known elevated risk of developing hypertension.
Design:
Cross-sectional study.
Setting:
Specialist outpatient clinic and patient homes.
Patients:
52 children and adolescents living with neurofibromatosis type 1.
Interventions:
Clinic BP measured thrice manually and once via an automated device; home BP measured daily with the same device for 3 days.
Main Outcome Measures:
Acceptability and feasibility were assessed with a Children's Anxiety Meter-State score, the comparability of home and clinic BPs, a parental survey, assessment of costs and the device return rate.
Results:
Home systolic BP and diastolic BP were statistically similar to both clinic manual (95% CI -4.78 to 0.13; -4.80 to 0.93) and automatic BPs (95% CI -4.44 to 2.08; -0.54 to 5.52). Anxiety scores (95% CI -0.57 to 0.35) were also similar between settings. Participants and their families reported that home BP measurement was easy, took ~10 min and minimally interrupted family life. Families also largely preferred home BP screening (73% 'yes', 23% 'not sure', 3% 'no'), and 90% returned their devices. Families reported substantial costs in attending clinic, which could be reduced with access to this home BP programme.
Conclusions:
Home BP screening was acceptable and feasible, with home BPs comparable to clinic measurements, no associated anxiety and preferred by families. Telehealth with home BP screening is a viable alternative to in-person appointments, which could reduce individual costs, and foster greater equity of care and access to health services.
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