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Effective Health Care Program

Self-Measured Blood Pressure: Future Research Needs

Systematic Review

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This report is from AHRQ's series on Future Research Needs Projects.

Structured Abstract

Background

Hypertension is an important public health issue. Self Measured Blood Pressure Monitoring (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control.

Purpose

Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an explicit a stakeholder-driven nomination and prioritization process.

Methods

Building on evidence gaps identified in a previous CER on SMBP, a preliminary list of future research needs (FRN) was supplemented and refined through input from stakeholders. Stakeholders were asked to indicate their top five priority topics considering the following dimensions in prioritization: (1) importance, (2) desirability of research/avoidance of unnecessary duplication, (3) feasibility, and (4) potential impact. The five topics with the highest number of stakeholder endorsements were identified as the prioritized FRN topics.

Future Research Needs Topics

Four priority topics pertain to interrelated evidence gaps such as the lack of longer term studies which show persistence of BP control or clinical benefit from SMBP, uncertainty regarding who is likely to benefit from SMBP, lack of standardization in prescription of SMBP, and uncertainty regarding the most effective additional support. The fifth topic relates to the inability to assess cost-effectiveness of SMBP, due to the deficiencies in evidence identified in the first four gaps.

To address these gaps, longer term randomized controlled trials are needed to examine clinical outcomes; exploration of treatment heterogeneity may identify those groups more likely to benefit from SMPB. Different prescriptions of SMBP should be compared in trials examining SMBP adherence and BP control. Additional support that shows promise for future study should be further refined by expert panels. Filling these evidence gaps will inform future modeling of cost-effectiveness.