Why SMBP Programs Are Helping Patients With Hypertension, and How You Can Implement One of Your Own

By Morgan Lenihan

Nearly 50% of adults in the U.S. have high blood pressure, or are taking medication for high blood pressure. That being said, only about 25% of all adults with hypertension have their condition under control. Blood pressure readings that qualify as hypertension/high blood pressure are considered 140/90 and above, with higher than 180/120 being regarded as severe. Hypertension is also a preventable risk factor for chronic conditions like stroke and heart disease amongst others. Not to mention, it is a major cause of premature deaths worldwide, which is why one of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 33% between by 2030.

One way in which we can work towards these improved statistics is through SMBP programs. SMBP stands for Self-Measured Blood Pressure monitoring. These refer to the regular monitoring of blood pressure by the patient outside of the clinical setting, whether that be home or elsewhere. Research has been done to provide strong scientific evidence for SMBP programs ability to help people with hypertension lower their blood pressure in combination with traditional clinical support. This clinical support might include one-on-one counseling, web-based or telemedicine support tools, and educational classes. Adding in SMBP initiatives to clinical care programs also increases the population size that can access hypertension resources, making healthcare more equitable and convenient for all patients.

SMBP monitoring programs involve the use of an at-home blood pressure measurement device. These can be purchased in a variety of different ways, but the most cost friendly approach would be through bulk ordering from a reputable medical device storefront. Purchasing individually from a pharmacy is typically more expensive, and is logistically difficult if you are thinking about implementing a SMBP program for a large number of patients. It’s important to utilize a website or storefront that details the different specifications between all of the available BP monitors on the market, as the decision can become overwhelming. Finding the right device for your SMBP program is a crucial step in the planning process, so it is important to consider factors such as price, connectivity, and power source. Our favorite medical device website that we would recommend for such a decision is The Digital Health Store. This website also ensures that you are only getting a clinically validated device, which is crucial for a successful SMBP program. You can bulk order blood pressure monitors, or browse through their wide selection to make an informed choice on thedigitalhealthstore.com.

These at home blood-pressure monitors allow patients to generate their own data into online records that their physicians and PCPs can view, track, and monitor. This allows for preventative interventions to be implemented by providers if they notice any abnormalities or unusual behaviors. Not to mention, a patients’ blood pressure can differ from factors such as stress, alcohol use, smoking, anxiety, physical exercise, and certain medical conditions such as sleep apnea and kidney disease. This supports the idea that an individual’s recorded BP can differ when recorded in versus outside of a clinical setting. Several national and international hypertension guidelines support the use of SMBP to help diagnose and treat white-coat hypertension and masked hypertension. A 2020 study conducted by the American Heart Association (AHA) and American Medical Association (AMA) concluded that SMBP is associated with lower blood pressure and a better ability to control blood pressure, and the greatest benefits were found from conjunction with in-office treatment as well.

SMBP monitoring programs can also be very cost effective, because these at-home interventions can help with reducing in-person follow-ups, avoidance of possible overtreatment of white-coat hypertension, improvement in quality of life, and reduction in cardiovascular events. However, some barriers to SMBP implementation come from costs as well. The out-of-pocket costs for patients to purchase a device can be daunting and unrealistic, which is why the AMA and AHA are working together to help advocate for coverage of devices through federally funded grant programs. However, the most beneficial use of SMBP requires an infrastructure of education and easy feedback loop of data communication between patient, device, and clinician. The Public Health Information Institute (PHII) proposed some recommendations to these problems, such as having a technical support and resources team to aid digital literacy, as well as developing a user-friendly patient application to easily transmit SMBP and patient health data to EHRs and clinicians.

If you are looking to apply for federal funding to implement a SMBP program for your own patients, there are a few requirements and procedures that need to be met. First, for eligibility your health center must agree to participate in the training and support activities for the patients, and must have served at least 100 patients between 18-85 with hypertension and have achieved controlled blood pressure in less than 58.9% of them. After eligibility has been determined, your program must make SMBP devices available to at least the majority (50% plus 1) of hypertensive patients, including both controlled and uncontrolled. It is important to note that health centers cannot just offer patients the device, they must also agree to train them on usage and educate them with proper resources about their condition, such as those found on Million Hearts, TargetBP, and AMA’s website. A good example of a SMBP program that received federal grants is the Office of Women's Health (OWH) BP program, which aims to improve the health outcomes of women through self-monitoring of blood pressure.

Here at Impilo, we can help you integrate SMBP monitoring programs into your virtual hypertension care plans. We easily integrate BP and other patient generated health data (PGHD) into our virtual platform. The data is straightforward and simply displayed so that both the patient and provider can understand and communicate this health data. This way, patients can take charge of their own health solutions, and professionals can dedicate their time towards providing care rather than technical issues with these devices. For more information on how Impilo can help integrate a SMBP program with you, reach out to sales@impilo.health or visit www.impilo.health.