Blood Pressure Self-Measurement in the Obstetric Waiting Room

Abstract

Pregnant diabetic patients are often required to self-measure their blood pressure in the waiting room before consultation. Currently used blood pressure devices do not guarantee valid measurements when used unsupervised. This could lead to misdiagnosis and treatment error. The aim of this study was to investigate current use of blood pressure self-measurement in the waiting room in order to identify challenges that could influence the resulting data quality. Also, we wanted to investigate the potential for addressing these challenges with e-health and telemedicine technology. We observed 81 pregnant diabetics' ability to correctly self-measure in the waiting room during a 4-week observational descriptive study. Specifically, we investigated the level of patient adherence to six recommendations with which patients are instructed to comply in order to obtain a reliable blood pressure reading. We found that the patients did not adhere to given instructions when performing blood pressure self-measurement in the waiting room. None of the 81 patients adhered to all six investigated recommendations, while around a quarter adhered to five out of six of the recommendations. The majority followed four or fewer of the recommendations. Results indicate that unsupervised self-measurement of blood pressure is not a reliable method. Thus, there is a need for increased staff presence and patient training or, alternatively, for introducing improved technology support. This could include context-aware patient adherence aids and clinical decision support systems for automatically validating self-measured data based on e-health and telemedicine technology.