Blood Pressure Protocol: Processing Time of Standard Versus Automated

Accurate blood pressure (BP) measurement is essential for hypertension diagnosis and management. While automated office blood pressure (AOBP) readings are increasingly used in many primary care settings, the challenges of implementing automated readings have not been fully explored in lower-resource settings. Our study compared patient processing times using standard care versus AOBP when indicated.

We collected data on the processing times of patients at an urban community health center for 1 month using standard care, including data on a second BP taken when the initial BP was >140/90 mmHg. The following month, we piloted a protocol wherein an initial BP of >140/90 would be followed by AOBP. We then compared average patient processing times between the two groups.

Of the 157 adult BP measurements taken during the study, 20% (32/157) had an initial BP >140/90. During the month of standard care, the mean processing time was 8.25 minutes (SD=3.6), which was not significantly different during the month of AOBP use, 8.38 minutes (SD=3.6; P=.84). Most patients in the AOBP group had an AOBP measurement of <140/90 (60%, n=27). Most (80%, n=12) of the patients whose AOBP remained >140/90 had their treatment plan discussed and revised.

The literature has established that AOBP may reduce clinical inertia by increasing confidence in BP accuracy. We conclude that AOBP protocol can be incorporated into clinic workflow without significantly impacting overall processing time.