Taking Control of Your Health: Self-Measured Blood Pressure Program in Yankton, South Dakota.

Background: Identification and management of hypertension is one of the most common problems for primary care providers. Rural settings have increased rates of hypertension due to a variety of factors including access to care, socioeconomic factors, and restricted strategies to identify hypertension outside of the clinic setting. To address this challenge, a self-measured blood pressure (SMBP) program was employed at a rural clinic in South Dakota with a goal of increasing the number of patients with well-controlled blood pressure.

Methods: One-hundred seventy-two patients aged 18-85 years with a primary residence of South Dakota were enrolled during a nine-month period. Two sets of home blood pressure measurements were taken twice a day for seven consecutive days and recorded by the patient. Controlled blood pressure was defined as systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg. The number of patients with controlled blood pressures were documented. Additionally, the number of patients with uncontrolled blood pressures requiring treatment plan or medication changes as a result of the program were recorded. Patient data was reviewed by the provider and utilized to make diagnosis and further recommendations.

Results: Eighty-eight out of the 172 patients were considered to have controlled blood pressure by the end of the study period without the need for interventions. Eighty-four patients required new medication or treatment plan changes throughout the study period in response to uncontrolled blood pressure readings obtained from the patients' blood pressure logs. Overall, patients reported appreciation for taking ownership in their health management through home blood pressure monitoring.

Conclusion: This work provides a framework to implement an SMBP program as a strategy to improve outpatient management of hypertension by empowering patients to take a greater, more active role in their health.