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Self-Measured Blood Pressure Monitoring

Slide: 19 of 27

Comparative Effectiveness of SMBP Monitoring With or Without Additional Support (1 of 2)

Evidence failed to support a difference between SMBP plus additional support versus SMBP without additional support or with less-intensive additional support for BP control; the strength of evidence for this finding was rated as low. This was based on data from 12 trials. Additional support in these trials consisted of a mixture of behavioral interventions by a nurse or pharmacist, medication management, educational interventions, electronic transmission of BP measurements, Web sites/training for patient-provider communication, telemonitoring, BP recording cards, BP and medication tracking tool, or home visits.

Four trials found statistically significant benefits for the more-intensive additional support for systolic BP, diastolic BP, or overall BP control or combinations thereof. The results of the other eight trials were indeterminate for a difference. Meta-analyses could not be performed due to clinical heterogeneity. The small number of studies and their distribution across different categories of additional support makes it impossible to draw conclusions regarding the potential effects of specific additional support or its interactions with SMBP.

There was no difference between SMBP with additional support versus SMBP without additional support or with less-intensive additional support for intermediate and surrogate outcomes, including medication number and dosage, medication adherence, quality of life, mental health, and adverse drug reactions. Inconsistency in findings and heterogeneity in definitions resulted in the strength of evidence being rated low for this finding.