Psychological effect of ambulatory blood pressure monitoring

Abstract

Diagnostic information from medical tests or procedures can significantly affect how patients view their health and well-being and may influence treatment outcomes. Ambulatory blood pressure monitoring (ABPM) is an important tool used in the diagnosis and management of hypertension.1 Pharmacists in ambulatory care settings are increasingly involved in using ABPM. The potential psychological effect of undergoing ABPM is unknown and not typically considered when referring patients for ABPM. We measured the effect of ABPM on patients’ perceptions of their health and well-being in a sample of patients referred to the pharmacist-managed ABPM referral service at the University of Iowa Hospitals and Clinics. The ABPM service has processed approximately 700 referrals since its inception in 2001. Details of the ABPM service have been described previously.2,3 All patients referred to the service between October 2006 and January 2008 were eligible for enrollment. Before and after their ABPM at the clinic, patients were administered a questionnaire assessing perceived life expectancy, anxiety about their current health condition, uncertainty about future health, and motivation for improving their health. Questions included short-answer and Likert-scale responses. The survey was modeled after a previously published questionnaire assessing the value of diagnostic information provided by exercise treadmill testing.4 Patients who did not complete a follow-up survey after completion of ABPM were excluded. Responses were pooled and descriptive statistics provided. Comparisons on measures of anxiety before and after ABPM were performed using the paired Student t test.