Home blood pressure measurement among hypertensive patients attending primary care clinic in rural Quebec

Context: Accurate blood pressure (BP) measurement is essential for the screening, diagnosis and management of hypertension. Although home blood pressure measurement (HBPM) has been recommended, a rigorous and equitable approach to HBPM has not yet been developed or implemented in Quebec primary healthcare settings.

Objectives: To estimate the prevalence of HBPM practice and factors associated with its use.

Study Design and Analysis: Cross-sectional, descriptive study.

Setting: Academic primary care clinic (GMF-U) in Amos (Northern Quebec, Canada).

Population studied: Hypertensive patients aged 18 years and above presenting during 8 recruitment days over a period of one month in March 2023.

Instrument: Data were collected using a validated self-administered questionnaire (adapted from Survey on Living with Chronic Diseases in Canada) that included questions on demographic characteristics, hypertension-related knowledge, and HBPM practice.

Outcome Measures: Prevalence and practice of HBPM.

Results: A total of 366 patients were approached, 192 met the eligibility criteria and 171 completed the paper (n=149) or online (n=22) questionnaire. The mean age of the participants was 61.9 (SD=12.7) years, on average participants reported living with hypertension for 9.7 years (SD=10.7), and 60.2% were female. Almost 90% reported having had their BP measured at least once in the past 12 months by a healthcare provider and of these, 44% were told by their healthcare provider that their BP was well controlled. Almost 81% of the participants reported measuring their blood pressure outside of a healthcare setting and a similar percentage (81.9%) indicated having a BP monitor at home. Among respondents who practiced HBPM, 71.3% shared their BP readings with their healthcare providers and 45.6% reported practicing HBPM regularly: daily (20.1%) or weekly (25.5%). The most common method of sharing BP readings (95.1%) was by writing them down on a piece of paper. Although 76.5% of participants reported that they were shown how to use BP monitor, only 44.5% indicated that they had good or very good HBPM knowledge.

Conclusion: The awareness and practice of HBPM among hypertensive patients attending an academic primary care clinic in rural Northern Quebec were high. However, strategies are needed to provide standardized guidance on HBPM use, and more efficient methods for sharing and integrating HBPM measurements in clinical practice by primary care teams.