Impact of Home Blood Pressure Data Visualization on Hypertension Medical Decision Making in Primary Care

Deborah J. Cohen; Tamar Wyte-Lake; Shannon M. Canfield; Jennifer D. Hall; Linsey Steege; Nuha K. Wareg; Richelle J. Koopman

doi:10.1370/afm.2820

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RE: Impact of Home Blood Pressure Data Visualization on Hypertension Medical Decision Making in Primary Care
Isaiah K. Boateng, Mark A. Kahwash, Ben Liu and Lorraine S. Wallace

Published on: 13 October 2022

Published on: (13 October 2022)
Page navigation anchor for RE: Impact of Home Blood Pressure Data Visualization on Hypertension Medical Decision Making in Primary Care
RE: Impact of Home Blood Pressure Data Visualization on Hypertension Medical Decision Making in Primary Care
Isaiah K. Boateng, Student Research Assistant, The Ohio State University
Other Contributors:
Mark A. Kahwash, Student

Ben Liu, Student

Lorraine S. Wallace, Associate Professor, Biomedical Education and Anatomy
As aspiring healthcare professionals, we were intrigued to learn about how using patients’ home blood pressure (BP) data could be incorporated into their primary care visits and potentially impact shared decision making. In reviewing study methods and results, we have several questions. The authors clearly articulate the need for increased patient access to home BP monitors. While increased patient access to home BP monitors is key, we believe that careful attention must also be directed towards ensuring that BP cuffs are standardized to minimize likelihood of data collection errors. Did you consider developing a protocol to guide optimal patient BP monitor use in the home setting? To increase accuracy of BP readings in the future, would it be worthwhile to demonstrate or provide targeted educational materials to illustrate correct BP use across all home monitoring systems?

We also noticed that more than half of the physicians participating in this study had between 6-20 years of clinical practice experience. In the future, it would be interesting to see if the same trends persist among family physicians who have less clinical experience. Have you considered replicating this study to capture a more diverse sample of family physicians and patients?
Additionally, did you consider assessing family physicians’ comfort level using this technology? We also noted that 16 (20% of total recordings) were removed from the sample pool due to technological difficulties....
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As aspiring healthcare professionals, we were intrigued to learn about how using patients’ home blood pressure (BP) data could be incorporated into their primary care visits and potentially impact shared decision making. In reviewing study methods and results, we have several questions. The authors clearly articulate the need for increased patient access to home BP monitors. While increased patient access to home BP monitors is key, we believe that careful attention must also be directed towards ensuring that BP cuffs are standardized to minimize likelihood of data collection errors. Did you consider developing a protocol to guide optimal patient BP monitor use in the home setting? To increase accuracy of BP readings in the future, would it be worthwhile to demonstrate or provide targeted educational materials to illustrate correct BP use across all home monitoring systems?

We also noticed that more than half of the physicians participating in this study had between 6-20 years of clinical practice experience. In the future, it would be interesting to see if the same trends persist among family physicians who have less clinical experience. Have you considered replicating this study to capture a more diverse sample of family physicians and patients?
Additionally, did you consider assessing family physicians’ comfort level using this technology? We also noted that 16 (20% of total recordings) were removed from the sample pool due to technological difficulties. We are curious to know what safeguards where instituted or could be established to reduce technology errors and/or challenges in the future.

Notably, there was not a significant difference between the paper and visualization tool in regard to visit efficiency. However, BP discussion time among patients with controlled hypertension patients was cut in half, which seems like a significant difference. Given this key finding, we are curious as to why overall visit efficiency remain did not improve in this patient sub-population as well.
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Competing Interests: None declared.