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Self-monitoring in hypertension: a web-based survey of primary care physicians

Journal of Human Hypertension volume 28, pages 123–127 (2014)Cite this article

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Abstract

Although self-monitoring of blood pressure is common among people with hypertension, little is known about how general practitioners (GPs) use such readings. This survey aimed to ascertain current views and practice on self-monitoring of UK primary care physicians. An internet-based survey of UK GPs was undertaken using a provider of internet services to UK doctors. The hyperlink to the survey was opened by 928 doctors, and 625 (67%) GPs completed the questionnaire. Of them, 557 (90%) reported having patients who self-monitor, 191 (34%) had a monitor that they lend to patients, 171 (31%) provided training in self-monitoring for their patients and 52 (9%) offered training to other GPs. Three hundred and sixty-seven GPs (66%) recommended at least two readings per day, and 416 (75%) recommended at least 4 days of monitoring at a time. One hundred and eighty (32%) adjusted self-monitored readings to take account of lower pressures in out-of-office settings, and 10/5 mm Hg was the most common adjustment factor used. Self-monitoring of blood pressure was widespread among the patients of responding GPs. Although the majority used appropriate schedules of measurement, some GPs suggested much more frequent home measurements than usual. Further, interpretation of home blood pressure was suboptimal, with only a minority recognising that values for diagnosis and on-treatment target are lower than those for clinic measurement. Subsequent national guidance may improve this situation but will require adequate implementation.

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Acknowledgements

We thank Jackie Howarth from the British Hypertension Society for assisting with the pilot. RJM is supported by an NIHR Career Development Fellowship. FDRH is an NIHR senior investigator.

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Authors and Affiliations

  1. Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK

    R J McManus, C Heneghan & F D R Hobbs

  2. Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK

    S Wood & E P Bray

  3. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia

    P Glasziou

  4. Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, New South Wales, Australia

    A Hayen

  5. Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK

    J Mant

  6. School of Clinical Sciences and Community Health, College of Medicine and Veterinary Science, University of Edinburgh, Edinburgh, UK

    P Padfield

  7. Ageing & Stroke Medicine Section, Norwich Medical School, University of East Anglia, Norwich, UK

    J F Potter

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  1. R J McManus
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  2. S Wood
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  3. E P Bray
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  6. C Heneghan
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  7. J Mant
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  8. P Padfield
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  9. J F Potter
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  10. F D R Hobbs
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Correspondence to R J McManus.

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Competing interests

RJM has received blood pressure monitors for research purposes from Omron and Lloyds Pharmacy. FDRH has received limited research support in terms of blood pressure devices from Microlife and BpTRU. The remaining authors declare no conflicts of interest.

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This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10347) and part funded in addition by the British Hypertension Society. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Supplementary Information accompanies this paper on the Journal of Human Hypertension website

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McManus, R., Wood, S., Bray, E. et al. Self-monitoring in hypertension: a web-based survey of primary care physicians. J Hum Hypertens 28, 123–127 (2014). https://doi.org/10.1038/jhh.2013.54

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