‘Diagnostic mode’ improves adherence to the home blood pressure measurement schedule

BACKGROUND: The accuracy of home blood pressure measurement (HBPM) depends on adherence to the measurement schedule. We investigated the number of deviations from the requested schedule using an HBPM device equipped with a diagnostic mode that only allows patients to take a fixed number of BP readings at preset times. METHODS: We randomized patients to measure their BP as recommended by the European Society of Hypertension guideline in either the usual mode or the diagnostic mode. RESULTS: A total of 135 patients were included, mean age 54.4 ± 13.6 years, 57 (42.2%) men, with a mean systolic BP of 147.0 ± 18.4 mmHg and a mean diastolic BP of 88.0 ± 10.3 mmHg. In 66 patients, BP was measured in the diagnostic mode, whereas in 69 patients BP was measured in the usual mode. In the diagnostic mode, 40% of patients showed full adherence to the measurement schedule, compared with 23% of patients in the usual mode (P = 0.02). Unscheduled measurements were performed by 55% of patients measuring BP in the usual mode and none in the diagnostic mode. The number of patients who omitted readings was similar in the diagnostic and the usual mode (P = 0.9). Compared with scheduled readings only, 12% of patients measuring BP in the usual mode fell into a different BP category, whereas reclassification did not occur in patients using the diagnostic mode (P = 0.03). CONCLUSION: HBPM in the diagnostic mode almost doubled the number of patients with full adherence to the measurement schedule and eliminated the number of patients who were reclassified in a different BP category.