Self-Measured Blood Pressure Monitoring in Primary Care: Retrospective Analysis from a Large US Healthcare System

Area of Science:

• Cardiovascular Medicine
• Health Informatics
• Health Equity

Background:

• Self-measured blood pressure (SMBP) monitoring is an evidence-based hypertension management strategy.
• Electronic health record (EHR) documentation of SMBP is critical for integrating it into routine care.
• The adoption of SMBP monitoring documentation within EHRs and its association with patient characteristics remain unclear.

Purpose of the Study:

• To evaluate the association between race/ethnicity, insurance status, and preferred language with documented SMBP monitoring adoption in the EHR.
• To identify disparities in the documentation of SMBP readings among diverse patient populations.

Main Methods:

• Retrospective study of adult patients (≥18 years) with hypertension and uncontrolled blood pressure readings in 2023.
• Analysis of EHR data for the presence of at least one documented SMBP reading.
• Logistic regression to assess associations between patient characteristics (race/ethnicity, insurance, language) and SMBP documentation.

Main Results:

• Only 5.0% of 156,444 eligible patients had documented SMBP readings in the EHR.
• SMBP readings were primarily recorded during office visits (62.8%).
• Lower odds of SMBP documentation were observed for Black, Hispanic, Medicaid-insured, and non-English preferring patients compared to White, commercially insured, and English preferring patients, respectively.

Conclusions:

• SMBP monitoring documentation in EHRs is infrequent and inequitably distributed.
• Poor EHR integration and scalability challenges hinder the adoption of remote monitoring.
• Targeted interventions are necessary to improve SMBP documentation workflows and promote equitable access to hypertension self-management tools.