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Cited by 145Blood Pressure and Hypertension StudiesClinical practice guidelines implementationHealth Promotion and Cardiovascular Prevention

Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States

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Kronish, Ian M., Kent, Shia, Moise, Nathalie, Shimbo, Daichi, Safford, Monika M., Kynerd, Robert E., O'Beirne, Ronan, Sullivan, Alexandra +1 more·2017·Journal of the American Society of Hypertension
DOI 10.1016/j.jash.2017.06.012PMC PMC5595651
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Abstract

In 2015, the US Preventive Services Task Force updated their hypertension recommendations to advise that adults with elevated office blood pressure (BP) undergo out-of-office BP measurement to exclude white coat hypertension before diagnosis. Our goal was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. We enrolled 63 primary care providers into nominal group panels in which participants iteratively listed and ranked barriers to ambulatory and home BP monitoring. Top-ranked barriers to ambulatory BP monitoring were challenges in accessing testing, costs of testing, concerns about the willingness or ability of patients to successfully complete tests, and concerns about the accuracy and benefits of testing. Top-ranked barriers to home BP monitoring were concerns about compliance with the correct test protocol, accuracy of tests results, out-of-pocket costs of home BP devices, and time needed to instruct patients on home BP monitoring protocol. Efforts to increase the use of ambulatory and home BP monitoring by primary care providers in the United States should prioritize increasing the financial and personnel resources available for testing and addressing provider concerns about patients' ability to conduct high-quality tests.

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Authors
Kronish, I. M., Kent, S., Moise, N., Shimbo, D., Safford, M. M., Kynerd, R. E., O'Beirne, R., Sullivan, A., & Muntner, P.
Affiliations
  • Columbia University Irving Medical Center (US)
  • University of Alabama at Birmingham (US)
Corresponding author
Kronish, Ian M.
ORCID
Venue
Journal of the American Society of Hypertension
Publisher
Elsevier BV
Published
2017-09
Volume
11
Issue
9
Pages
573-580
ISSN
  • 1878-7436 (ISSN-L)
  • 1933-1711
DOI
10.1016/j.jash.2017.06.012
PMC
PMC5595651
OpenAlex
W2724277155
Cited by
145
References
4
Citations by year
2026: 13 · 2025: 18 · 2024: 19 · 2023: 15 · 2022: 20 · 2021: 15 · 2020: 18 · 2019: 15 · 2018: 12
FWCI
9.52
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Society of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Agency for Healthcare Research and Quality (R01-HS024262)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
ambulatory blood pressure monitoring, home blood pressure monitoring, hypertension screening, white coat hypertension, barriers to testing, primary care providers, out-of-office blood pressure measurement, USPSTF recommendations, medication adherence, out-of-pocket costs
MeSH terms
Adult, Blood Pressure, Health Expenditures, Female, Humans, Hypertension, Male, Mass Screening, Middle Aged, Patient Compliance, Patient Education as Topic, Primary Health Care, Time Factors, United States, Practice Guidelines as Topic, Blood Pressure Monitoring, Ambulatory, Health Literacy

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