Cited by 13Blood Pressure and Hypertension StudiesMobile Health and mHealth ApplicationsHealth Systems, Economic Evaluations, Quality of Life

Systematic Review of Self-Measured Blood Pressure Monitoring With Support: Intervention Effectiveness and Cost

Open access
Shantharam, Sharada S., Mahalingam, Mallika, Rasool, Aysha, Reynolds, Jeffrey A., Bhuiya, Aunima R., Satchell, Tyra D., Chapel, John M., Hawkins, Nikki A. +3 more·2022·American Journal of Preventive Medicine

Abstract

Introduction Self-measured blood pressure monitoring with support is an evidence-based intervention that helps patients control their blood pressure. This systematic economic review describes how certain intervention aspects contribute to effectiveness, intervention cost, and intervention cost per unit of the effectiveness of self-measured blood pressure monitoring with support.Methods Papers published between data inception and March 2021 were identified from a database search and manual searches. Papers were included if they focused on self-measured blood pressure monitoring with support and reported blood pressure change and intervention cost. Papers focused on preeclampsia, kidney disease, or drug efficacy were excluded. Quality of estimates was assessed for effectiveness, cost, and cost per unit of effectiveness. Patient characteristics and intervention features were analyzed in 2021 to determine how they impacted effectiveness, intervention cost, and intervention cost per unit of effectiveness.Results A total of 22 studies were included in this review from papers identified in the search. Type of support was not associated with differences in cost and cost per unit of effectiveness. Lower cost and cost per unit of effectiveness were achieved with simple technologies such as interactive phone systems, smartphones, and websites and where providers interacted with patients only as needed.Discussion Some of the included studies provided only limited information on key outcomes of interest to this review. However, the strength of this review is the systematic collection and synthesis of evidence that revealed the associations between the characteristics of implemented interventions and their patients and the interventions' effectiveness and cost, a useful contribution to the fields of both research and implementation.

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Crossref · 10.1016/j.amepre.2021.06.025

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  • The ROI of RPM depends on the specific clinical setting and available resources.

    “The ROI of RPM depends on the specific clinical setting and available resources.7,24,25”

    From Program cost and return on investment analysis of remote patient monitoring for hypertension management in the cardiology department of a large healthcare system (2026) · cites this paper as [24]

    The Results (Intervention Effect, Cost, and Cost per Unit of Effectiveness; page unavailable) associate some intervention features with differences in cost and cost per unit of effectiveness for supported self-measured blood-pressure monitoring. The paper does not calculate return on investment or establish that ROI for RPM generally depends on clinical setting and available resources. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • Data review is essential in RPM-HTN programs to facilitate successful home-based monitoring, aid patients in managing hypertension, administer antihypertensive medications, detect masked hypertension, and help avoid emergencies that could escalate to higher-acuity care.

    “While meticulous, this process is essential in RPM-HTN programs to facilitate successful home-based monitoring, aid patients in managing hypertension, administer antihypertensive medications, detect masked hypertension, and help avoid emergencies that could escalate to higher-acuity care.24–27”

    From Program cost and return on investment analysis of remote patient monitoring for hypertension management in the cardiology department of a large healthcare system (2026) · cites this paper as [24]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • The Community Preventive Services Task Force recommends the use of RPM to reduce BP, citing its proven effectiveness and cost-effectiveness.

    “The Community Preventive Services Task Force recommends the use of RPM to reduce BP, citing its proven effectiveness and cost-effectiveness.24”

    From Program cost and return on investment analysis of remote patient monitoring for hypertension management in the cardiology department of a large healthcare system (2026) · cites this paper as [24]

    The Introduction says the CPSTF recommends self-measured blood pressure monitoring (SMBP) to reduce and control BP. It also says SMBP *with support* is cost-effective, but evidence for SMBP without support is mixed. The source does not state a recommendation for RPM generally or establish cost-effectiveness for all forms of it. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • Intervention protocols triggering patient-provider interactions on an as-needed basis, rather than at a standardized frequency, were associated with lower costs and greater effectiveness.

    “Previous research has shown that intervention protocols triggering patient-provider interactions on an as-needed basis, rather than at a standardized frequency, were associated with lower costs and greater effectiveness.24”
  • Patient compliance is one of the most critical factors influencing the ROI and sustainability of the RPM-HTN program.

    “Patient compliance is one of the most critical factors influencing the ROI and sustainability of the RPM-HTN program.24”

    From Program cost and return on investment analysis of remote patient monitoring for hypertension management in the cardiology department of a large healthcare system (2026) · cites this paper as [24]

    The Results (Intervention Features; page unavailable) describe support for medication adherence, and the Results (Intervention Effect, Cost, and Cost per Unit of Effectiveness; page unavailable) associate technologies that facilitate patient engagement with greater effectiveness. Neither passage evaluates patient compliance as a factor in return on investment or program sustainability. Searches for compliance, return on investment, and sustainability found no passage making that claim. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 8

  1. [5]Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015–2016. NCHS Data Brief. 2017(289): 1– 8. https://www.cdc.gov/nchs/data/databriefs/db289.pdf. Accessed July 14, 2020. 29155682
  2. [15]National Heart, Lung, and Blood Institute. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Bethesda, MD: National Heart, Lung, and Blood Institute; December 2003. https://www.nhlbi.nih.gov/files/docs/guidelines/express.pdf. Published December 2003. Accessed August 2, 2021. 20821851
  3. [27]Sharman JE, Howes FS, Head GA, Home blood pressure monitoring: Australian Expert Consensus Statement. J Hypertens. 2015; 33 (9): 1721– 1728. 10.1097/HJH.0000000000000673. 26136205 PMC4671913 · DOI · Paper page
  4. [34]Briss PA, Zaza S, Pappaioanou M, Developing an evidence-based guide to community preventive services–methods. The Task Force on Community Preventive Services. Am J Prev Med. 2000; 18(1): 35– 43 (suppl). 10.1016/s0749-3797(99)00119-1. 10806978 · DOI
  5. [37]Totten AM, Womack DM, Eden KB, Telehealth: mapping the evidence for patient outcomes from systematic reviews. Rockville, MD: Agency for Healthcare Research and Quality (U.S.). https://www.ncbi.nlm.nih.gov/books/NBK379320/pdf/Bookshelf_NBK379320.pdf. Published June 2016. Accessed February 1, 2021. 27536752
  6. [44]Magid DJ, Olson KL, Billups SJ, Wagner NM, Lyons EE, Kroner BA. A pharmacist-led, American Heart Association Heart 360 Web-enabled home blood pressure monitoring program. Circ Cardiovasc Qual Outcomes. 2013; 6(2): 157– 163. 10.1161/CIRCOUT-COMES.112.968172. 23463811 · DOI
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  8. [54]Katon W, Russo J, Lin EH, Cost-effectiveness of a multicondition collaborative care intervention: a randomized controlled trial. Arch Gen Psychiatry. 2012; 69(5): 506– 514. 10.1001/archgen-psychiatry.2011.1548. 22566583 PMC3840955 · DOI

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Authors
Shantharam, S. S., Mahalingam, M., Rasool, A., Reynolds, J. A., Bhuiya, A. R., Satchell, T. D., Chapel, J. M., Hawkins, N. A., Jones, C. D., Jacob, V., & Hopkins, D. P.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Shantharam, Sharada S.
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2022-02
Volume
62
Issue
2
Pages
285-298
ISSN
0749-3797 (ISSN-L)
OpenAlex
W3205732087
Cited by
13
References
61
Citations by year
2026: 3 · 2025: 5 · 2024: 1 · 2023: 2 · 2022: 2
FWCI
0.24
Type
journal article
Language
en
Open access
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
self-measured blood pressure, blood pressure control, intervention costs, patient support, mobile application, online health interventions, antihypertensive therapy, intervention characteristics
MeSH terms
Blood Pressure, Blood Pressure Determination, Cost-Benefit Analysis, Female, Humans, Pregnancy

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