Abstract P014: A Pilot Study To Develop A Telehealth Program For Self-Measured Blood Pressure Education And Assessment Within A Veterans Affairs Clinic

Abstract

Background: Lack of education and assessment of self-measured blood pressure (BP) monitoring quality is a barrier to its widespread implementation. Objective: To develop a pilot Veterans Affairs (VA) Telehealth Program utilizing a tool to educate and assess competencies in self-measured BP technique. Methods: This pilot study was implemented in a single VA primary care clinic. Veterans aged 18 to 85 years old with an office-based BP measurement of ≥140/90 or ≥130/80 mmHg and high cardiovascular disease risk were eligible. Enrolled Veterans completed a four-week program whereby trained registered nurses (RNs) educated Veterans on self-measured BP techniques via video conferencing. At each visit, RNs conducted an 11-part assessment tool (Figure Top) adapted from the American Medical Association measurement skills assessment for patient self-measured BP technique. Results: Forty Veterans (mean age 66 years [SD 12.6], 100% male) were referred for enrollment and twenty completed the program. Veterans demonstrated overall high scores on self-BP measurement skills assessment at each time point (Figure Top), but most frequent skills with non-adherence included: avoiding stimulant use prior to BP measurement; emptying bladder; resting quietly for 3-5 minutes; and talking or using a personal device during measurement. Mean SBP and DBP generally declined over time from a baseline mean SBP and DBP of 147.9 and 81.7 mmHg at enrollment to a mean of 140.4 and 79.9 mmHg, respectively, at program completion (Figure Bottom). Conclusions: Education and assessment of self-measured BP technique may serve as a meaningful target for future education and quality improvement efforts.