Key result
Consumer BP monitors reduce systolic BP by ~3 mm Hg, but health outcomes remain unclear.
Why the study?
Despite widespread use of consumer blood pressure monitors collecting patient-generated health data, it remained unclear whether these devices improve health outcomes.
Do consumer blood pressure monitors reduce blood pressure and improve health outcomes in patients managing hypertension?
Systematic Review
Do consumer blood pressure monitors reduce blood pressure and improve health outcomes in patients managing hypertension?
Consumer blood pressure monitors offer small benefits in terms of blood pressure reduction, but their impact on hard clinical health outcomes remains unclear.
Small BP reductions support adjunctive consumer monitor use in hypertension; extends efficacy data but leaves hard outcome effects open.
BACKGROUND: In the era of digital health information technology, there has been a proliferation of devices that collect patient-generated health data (PGHD), including consumer blood pressure (BP) monitors. Despite their widespread use, it remains unclear whether such devices can improve health outcomes. OBJECTIVE: We performed a systematic review of the literature on consumer BP monitors that collect PGHD for managing hypertension to summarize their clinical impact on health and surrogate outcomes. We focused particularly on studies designed to measure the specific effect of using a BP monitor independent of cointerventions. We have also summarized the process and consumer experience outcomes. METHODS: An information specialist searched PubMed, MEDLINE, and Embase for controlled studies on consumer BP monitors published up to May 12, 2020. We assessed the risk of bias using an adapted 9-item appraisal tool and performed a narrative synthesis of the results. RESULTS: We identified 41 different types of BP monitors used in 49 studies included for review. Device engineers judged that 38 (92%) of those devices were similar to the currently available consumer BP monitors. The median sample size was 222 (IQR 101-416) participants, and the median length of follow-up was 6 (IQR 3-12) months. Of the included studies, 18 (36%) were designed to isolate the clinical effects of BP monitors; 6 of the 18 (33%) studies evaluated health outcomes (eg, mortality, hospitalizations, and quality of life), and data on those outcomes were unclear. The lack of clarity was due to low event rates, short follow-up duration, and risk of bias. All 18 studies that isolated the effect of BP monitors measured both systolic and diastolic BP and generally demonstrated a decrease of 2 to 4 mm Hg in systolic BP and 1 to 3 mm Hg in diastolic BP compared with non-BP monitor groups. Adherence to using consumer BP monitors ranged from 38% to 89%, and ease of use and satisfaction ratings were generally high. Adverse events were infrequent, but there were a few technical problems with devices (eg, incorrect device alerts). CONCLUSIONS: Overall, BP monitors offer small benefits in terms of BP reduction; however, the health impact of these devices continues to remain unclear. Future studies are needed to examine the effectiveness of BP monitors that transmit data to health care providers. Additional data from implementation studies may help determine which components are critical for sustained BP improvement, which in turn may improve prescription decisions by clinicians and coverage decisions by policy makers.
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Treadwell et al. (2022) conducted a systematic review in Hypertension. Consumer blood pressure monitors vs. Usual care or non-BP monitor groups was evaluated on Systolic and diastolic blood pressure. Consumer blood pressure monitors generally demonstrated a decrease of 2 to 4 mm Hg in systolic BP and 1 to 3 mm Hg in diastolic BP compared with non-BP monitor groups, though their impact on health outcomes remains unclear.
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