Feasibility of home blood pressure screening in the paediatric outpatient clinic setting

OBJECTIVE: The aim of this study was to evaluate the acceptability and feasibility of home-based blood pressure (BP) screening in a group of paediatric patients with known elevated risk of developing hypertension. DESIGN: Cross-sectional study. SETTING: Specialist outpatient clinic and patient homes. PATIENTS: 52 children and adolescents living with neurofibromatosis type 1. INTERVENTIONS: Clinic BP measured thrice manually and once via an automated device; home BP measured daily with the same device for 3 days. MAIN OUTCOME MEASURES: Acceptability and feasibility were assessed with a Children's Anxiety Meter-State score, the comparability of home and clinic BPs, a parental survey, assessment of costs and the device return rate. RESULTS: Home systolic BP and diastolic BP were statistically similar to both clinic manual (95% CI -4.78 to 0.13; -4.80 to 0.93) and automatic BPs (95% CI -4.44 to 2.08; -0.54 to 5.52). Anxiety scores (95% CI -0.57 to 0.35) were also similar between settings. Participants and their families reported that home BP measurement was easy, took ~10 min and minimally interrupted family life. Families also largely preferred home BP screening (73% 'yes', 23% 'not sure', 3% 'no'), and 90% returned their devices. Families reported substantial costs in attending clinic, which could be reduced with access to this home BP programme. CONCLUSIONS: Home BP screening was acceptable and feasible, with home BPs comparable to clinic measurements, no associated anxiety and preferred by families. Telehealth with home BP screening is a viable alternative to in-person appointments, which could reduce individual costs, and foster greater equity of care and access to health services.