Abstract 16560: Home Blood Pressure Monitoring Among Hypertensive Patients and Their Caregivers in a North Indian Population

Abstract

Introduction: Hypertension (HTN) management guidelines recommend home blood pressure monitoring (HBPM) as an important tool for BP control. Limited data exists on HBPM epidemiology among people with HTN and their caregivers in the Indian context. Aim: Assess the prevalence, training and technique of HBPM among people with HTN and their caregivers. Methods: People with HTN diagnosed >3 months ago, and their caregivers, were screened from outpatient departments of 3 hospitals (1 tertiary care, 2 community level) in North India and their HBPM use was evaluated. HBPM practices were assessed by observing participants measuring BP using a pre-validated, structured 16-point observational checklist. HBPM knowledge was assessed using a 19-point self-administered questionnaire based on 2017 AHA guidelines. Responses were graded and classified based on quartiles. Results: A total of 2750 participants were screened, of which 2588 (48.8% female) were included. The proportion of respondents using HBPM was 20.5% (424/2070) in urban, and 8.5% (44/518) in rural areas. Only 24.7% (n=116) of the 468 participants (232 caregivers) measuring BP at home recalled ever receiving training from any healthcare workers. The majority (75.2%, 352/468) of participants reported learning BPM themselves through observation, videos, and reading. Age, gender, residence, education and occupation had no impact on the length of time participants had used HBPM. In HPBM practice assessment, 15.9% of people with HTN (37/232) vs 5.9% caregivers (14/236) scored excellent (score >75%). In HPBM knowledge assessment, 0.4% of people with HTN (1/232) vs 0 caregivers scored excellent. HPBM practices were better than knowledge, with mean scores of 62.3 ± 13.1% and 40.1 ± 16.2% respectively. Higher education level was associated with improved patient knowledge (p=0.041), but not practices (p=0.225).The most common reason for non-use of HBPM was lack of knowledge of BPM (36.1%, 171/474) in rural areas, and most people in urban areas feeling it was not necessary (41.1%, 677/1646). Conclusion: There is need for more robust training on HBPM to enable affording people from all backgrounds to better manage their BP, especially in rural areas. Education level is not a barrier to learning good BPM technique.