Teaching hypertension management with home blood pressure monitoring: beliefs versus actions

Research Statement
In this pilot, we evaluated family medicine residents’ and attendings’ beliefs about the importance of home BP monitoring and how often they recommended home BP checks to patients.

Background and relevance of the study
In the US, 88 million adults have uncontrolled hypertension (HTN). The American Heart Association strongly recommends home blood pressure (BP) monitoring for patients with HTN to improve BP control and as a result, overall health. Therefore, teaching residents about home BP monitoring is key.

Design and Methods
The University of Hawaii Department of Family Medicine and Community Health surveyed residents and attendings anonymously online in May 2022 about their beliefs and practices regarding patients’ home BP monitoring.

Results
A total of 26 clinicians (20 residents, 6 attendings) participated (response rate 79%). Nearly all (92%) felt it was important for patients to check home BPs although most (77%) reported that fewer than half of their patients with HTN did so. Despite this, only some respondents reported always asking patients with HTN to check home BPs even for their patients with poorly controlled (58%) or newly diagnosed (46%) HTN.

Conclusions
Although 92% of family medicine residents and attendings in our clinic felt that checking home BPs was important for patients with HTN, less than 60% always asked their patients with HTN to do so.

Significance
This disconnect between clinicians’ beliefs and actions in encouraging patients to check home BPs must be addressed to improve care for patients with HTN.