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Primary care physician beliefs regarding usefulness of self-monitoring of blood pressure

Cheng, Cynthia; Studdiford, James S.; Diamond, James J.; Chambers, Christopher V.

Clinical and Pathophysiologic Studies
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Background Recent studies suggest that the self-monitoring of blood pressure (SMBP) may improve the identification and control of hypertension. Although endorsed by the Joint National Committee VII guidelines, home monitoring is not currently part of the standard care of hypertension.

Objective To assess community- and university-based primary care physicians' opinions of SMBP.

Methods A written, 5-point, Likert-scale questionnaire was mailed to physicians in a primary care research network.

Results We received completed surveys from 138 of 170 providers (81%). Physician ages ranged from 25 to 72 years. Half of the providers were female, and approximately half were residents. Most physicians (63%) reported having patients using SMBP. Physician opinions of SMBP were unrelated to age, gender and number of years in practice. Three key beliefs were expressed: SMBP could be useful, economical and problematic. Community-based physicians were more likely than university-based physicians to believe in the benefits of SMBP use, and to disagree that the use of SMBP could cause problems for them or their patients (P < 0.05). Compared with their peers, physicians with fewer than five patients using SMBP agreed more strongly with statements that SMBP use could cause problems for themselves and their patients in hypertension treatment.

Conclusions Overall, the providers responded that SMBP could be useful to them in managing hypertension but seem hesitant to endorse it fully at this time, possibly anticipating potential problems that could arise with SMBP use. Physicians with more patients using self-monitoring were more likely to endorse it.

Department of Family Medicine, Thomas Jefferson University, Philadelphia, USA

Sponsorship: Partial funding was provided by Omron Healthcare, Incorporated, The Edna G. Kynett Memorial Foundation, Novartis Pharmaceuticals Corporation, and a grant from the Health Resources and Services Administration, USA

Potential conflicts of interest: None

Previous presentations: The results of this study were presented at the American Society of Hypertension Meeting, San Francisco, California, USA in May 2001.

Correspondence and requests for reprints to Cynthia Cheng MD, PhD, Department of Family Medicine, Thomas Jefferson University, 1015 Walnut Street, Suite 401 Curtis, Philadelphia, PA 19107, USA

Tel: +1 215 955 0641; fax: +1 215 923 6256;

e-mail: cynthia.cheng@jefferson.edu

Received 18 October 2002 Revised 08 October 2003 Accepted 22 October 2003

© 2003 Lippincott Williams & Wilkins, Inc.