Self-monitoring blood pressure in patients with hypertension: an internet-based survey of UK GPs

Benjamin R Fletcher, Lisa Hinton, Emma P Bray, Andrew Hayen, FD Richard Hobbs, Jonathan Mant, John F Potter, Richard J McManus

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21 Citations (Scopus)
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Abstract

Background: Previous research suggests that most GPs in the UK use self-monitoring of blood pressure (SMBP) to monitor the control of hypertension rather than for diagnosis. This study sought to assess current practice in the use of self-monitoring and any changes in practice following more recent guideline recommendations. Aim: To survey the views and practice of UK GPs in 2015 with regard to SMBP and compare them with a previous survey carried out in 2011. Design and setting: Web-based survey of a regionally representative sample of 300 UK GPs. Method: GPs completed an online questionnaire concerning the use of SMBP in the management of hypertension. Analyses comprised descriptive statistics, tests for between-group differences (z, Wilcoxon signed-rank, and χ2 tests), and multivariate logistic regression. Results: Results were available for 300 GPs (94% of those who started the survey). GPs reported using self-monitoring to diagnose hypertension (169/291; 58%; 95% confidence interval (CI) = 52 to 64) and to monitor control (245/291; 84%; 95% CI = 80 to 88), the former having significantly increased since 2011 (from 37%; 95% CI = 33 to 41; P<0.001) with no change in monitoring for control. More than half of GPs used higher systolic thresholds for diagnosis (118/169; 70%; 95% CI = 63 to 77) and treatment (168/225; 75%; 95% CI = 69 to 80) than recommended in guidelines, and under half (120/289; 42%; 95% CI = 36 to 47) adjusted the SMBP results to guide treatment decisions. Conclusion: Since new UK national guidance in 2011, GPs are more likely to use SMBP to diagnose hypertension. However, significant proportions of GPs continue to use non-standard diagnostic and monitoring thresholds. The use of out-of-office methods to improve the accuracy of diagnosis is unlikely to be beneficial if suboptimal thresholds are used.
Original languageEnglish
Pages (from-to)e831-e837
Number of pages7
JournalBritish Journal of General Practice
Volume66
Issue number652
Early online date27 Oct 2016
DOIs
Publication statusPublished - 1 Nov 2016

Keywords

  • self blood pressure monitoring
  • general practice
  • hypertension

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