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

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.