Self-measured blood pressure (BP) monitoring interventions can improve both patient care and cost of healthcare, according to a study review published in the American Journal of Preventive Medicine.
The systematic economic review included 22 studies sourced from multiple databases, including MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Economic Evaluations, EconLit, and Centre for Reviews and Dissemination. Patients had a mean age of 63.0 years and 51.3% were women. Data on cost effectiveness were collected by the Community Preventive Services Task Force (CPSTF) through March 2015, with a bridge search using CPSTF methods extending the review period through March 2021.
Included studies focused on self-measured BP monitoring and included intervention cost and change in blood pressure. Given the heterogeneity of the included studies, a qualitative analysis was conducted to answer the research questions. Cost, effectiveness, and cost per unit of effectiveness were assessed for quality of estimates. All intervention features and participant characteristics were analyzed near the end of the study to assess how they affected cost, effectiveness, and cost per unit effectiveness.
Among the included studies, no association was identified between the type of support and either difference in cost or cost per unit of effectiveness. Technological tools, such as smartphones, interactive phone systems, and websites were associated with lower cost and cost per unit of effectiveness, as were as-needed provider-participant interactions.
Limitations to this study include a lack of accounting for certain covariates, such as intervention cost and effectiveness, a lack of coverage information for the devices, and a lack of representativeness in the study samples.
The study authors concluded that “[Self-measured BP] interventions with support can beneficially impact patient care and healthcare costs.” They also noted that “future research in [self-measured BP] monitoring interventions, including standardized information and reimbursement for [self-measured] BP devices, may support implementation in specific settings.”
Shantharam SS, Mahalingam M, Rasool A, et al. Systematic review of self-measured blood pressure monitoring with support: intervention effectiveness and cost. Am J Prev Med. Published online October 19, 2021. doi: 10.1016/j.amepre.2021.06.025