scholarly journals Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP) Through Clinical-Community Care Models

2020 ◽  
Vol 46 (1) ◽  
pp. 127-138
Author(s):  
Margaret Meador ◽  
Judy Hannan ◽  
Debosree Roy ◽  
Kate Whelihan ◽  
Nana Sasu ◽  
...  

AbstractSelf-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National Association of Community Health Centers, the YMCA of the USA, and Association of State and Territorial Health Officials to develop cross-sector care models to offer SMBP to patients with hypertension. The project aimed to increase the use of SMBP through the coordinated action of health department leaders, community organizations and clinical providers. From 1/31/2017 to 6/30/2018, nine health centers in Kentucky, Missouri, and New York partnered with seven local Y associations (local Y) and their local health departments to design and implement care models that adapted existing primary care SMBP practices by leveraging capacities and resources in community and public health organizations. Nine collaborative care models emerged, shaped by available community assets, strategic priorities, and organizational culture. Overall, 1421 patients were recommended for SMBP; of those, 795 completed at least one cycle of SMBP (BP measurements morning and evening for at least three consecutive days). Of those recommended for SMBP, 308 patients were referred to a local Y to receive additional SMBP and healthy lifestyle support. Community and public health organizations can be brought into the health care delivery process and can play valuable roles in supporting patients in SMBP.

2014 ◽  
Vol 16 (2) ◽  
pp. e31 ◽  
Author(s):  
Jenine K Harris ◽  
Bechara Choucair ◽  
Ryan C Maier ◽  
Nina Jolani ◽  
Jay M Bernhardt

2017 ◽  
Vol 25 (1) ◽  
pp. 35-45 ◽  
Author(s):  
Ju-Fen Lu ◽  
Ching-Min Chen ◽  
Chien-Yeh Hsu

Objective This study aimed to evaluate the effectiveness of home telehealth care combined with case management by public health nurses, in improving blood pressure control in patients with hypertension. Methods This cohort study examined the data of patients with hypertension obtained from a telehealth service centre database, between July 2011– June 2012. Eligible patients were adults (≥40 years old) with both prehypertension and hypertension, living alone or in the remote suburbs of metropolitan areas. Demographic data were collected from 12 district public health centre in Taipei, Taiwan. Following enrolment, patients received an appropriate and validated home telehealth device kit for automatic blood pressure monitoring and automated modem via a telephone line or a desktop computer with Internet connection to enable data transmission between the patient’s home and telehealth service centre. Patients were instructed to upload the measured data immediately every day. The study outcomes included blood pressure and home telehealth service utilisation. Results Of the 432 patients recruited, 408 (94%) completed data collection. Linear regression analysis found an average 22.1 mm Hg reduction in systolic blood pressure after one year. The mean slope of systolic blood pressure was classified as decreased or non-decreased. An systolic blood pressure decreasing trend was observed in 52.2% patients, while 47.8% patients showed an increasing systolic blood pressure trend. Patients in the decreased systolic blood pressure group tended to be older ( p = 0. 0001), with a greater proportion of hypertension alarms ( p = 0. 001), improved self-blood pressure monitoring behaviour ( p = 0.009) and higher self-measured blood pressure monitoring frequency ( p = 0. 010). Patients in the decreased systolic blood pressure group had a higher self-measured blood pressure monitoring frequency (odds ratio = 0.95, 95% confidence interval, 0.91–0.99, p = 0. 013) than their counterparts. Conclusions Home telehealth care combined with care management by public health nurses based in public health care centre was feasible and effective for improving blood pressure control among patients with hypertension. Further studies should conduct a thorough analysis of the cost-effectiveness of this intervention. A randomised controlled trial with a longer follow-up period is required to examine the effects of the improved home telehealth device kit on the care of patients with hypertension.


2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Adelaide Ippolito ◽  
Cira Impagliazzo ◽  
Paola Zoccoli

The paper analyses how customers of public health organizations can express their dissatisfaction for the services offered to them. The main aim is to evaluate the effects that possible dissatisfaction of Italian public health service customers can have on public health organizations. We adopted the methodological scheme developed by Hirschman withexit, voice,andloyalty, considering the macroeconomic and corporate implications that it causes for Italian public health organizations. The study investigated the effects developed by exit of the patients on the system of financing of local health authorities considering both the corporate level of analysis and the macroeconomic level. As a result, local health authority management is encouraged to pay greater attention to theexitphenomena through the adoption of tools that promote loyalty, such as the promotion of voice, even ifexitis not promoting, at a macroeconomic level, considerable attention to this phenomenon.


2014 ◽  
Author(s):  
Francisco Javier Vilchez-Lopez ◽  
Isabel Mateo-Gavira ◽  
Florentino Carral-San Laureano ◽  
Maria Victoria Garcia-Palacios ◽  
Jose Ortego-Rojo ◽  
...  

2020 ◽  
Vol 111 (6) ◽  
Author(s):  
Ramón C. Hermida ◽  
Artemio Mojón ◽  
José R. Fernández ◽  
Alfonso Otero ◽  
Juan J. Crespo ◽  
...  

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