Home Medical Equipment is Highly Being Adopted in U.S. – Explore Why?

The modern technological advancements and facilities have made people welcome medical equipment to home. Most common home medical equipment include glucometer, automated external defibrillators, blood glucose monitors, blood pressure monitors, halter monitors, mobility devices, weighing scale and so on. These equipment can provide safe, convenient, cost-effective, and suitable treatments to patients at home.

Usability Evaluation Methods Used to Ensure the Usability of the MEDSReM-2 System

A key objective of the MEDSReM-2 study is to promote medication taking decisions and improve adherence to hypertensive medications for older adults. New functionalities include enhanced decision-support algorithms for missed medications, automated entry of blood pressure measurements, improved data visualizations, and an easy-to-use online web portal. In support of these enhancements, the User Testing subteam is tasked with providing ongoing evaluation and feedback on the usability of early design concepts, prototypes, beta software, wireless blood pressure monitors, and instructional materials. The overall project comprises multiple working teams, whose efforts must be coordinated. We will describe the challenges of working with these interdisciplinary teams and the usability evaluation methods used to support the needs of each team in creating the enhanced MEDSReM-2 system that is easy-to-use and effective in helping older adults improve their hypertension medication adherence. These processes inform the research and design efforts of other technology interventions.

Accuracy of BP monitors used at home

Overview of: Hodgkinson JA, Lee MM, Milner S, et al. Accuracy of blood-pressure monitors owned by patients with hypertension (ACCU-RATE study): a cross-sectional, observational study in central England. Br J Gen Pract. 2020;70:e548–e554.

Systematic Review of Consumer Devices for Patient Generated Health Data Using Blood Pressure Monitors for Managing Hypertension (Preprint)

UNSTRUCTURED In the era of digital health information technology, the approach to managing and monitoring blood pressure out-of-office has led to a proliferation of devices collecting patient generated health data (PGHD), including consumer blood pressure (BP) monitors. Despite abundant usage, it remains unclear whether such devices improve health outcomes. We performed a systematic review of consumer blood pressure monitors collecting PGHD to summarize their clinical impact on health and surrogate outcomes. We also summarize process and consumer experience outcomes. An information specialist searched Pubmed, MEDLINE, and EMBASE for controlled studies published up to May 12, 2020. The 49 included studies used 41 different BP monitors. Device engineers judged 38 out of 41 of those as similar to currently available consumer BP monitors. Seventeen of the included studies were designed to isolate the clinical effect of BP monitoring. Six of these studies evaluated health outcomes, and the corresponding data were unclear. All 17 studies that isolated the effect of BP monitors measured systolic and diastolic BP and generally demonstrated a decrease of 2-4 mmHg compared to non-PGHD groups. Adherence to using consumer BP monitors ranged from 38% to 89% and ease of use and satisfaction ratings were generally high. Harms were infrequent, but there were a few technical device problems (e.g., incorrect device alerts). Overall, we found these devices to offer small benefits in blood pressure reduction; however the health impact of these devices continue to remain unclear.

Home blood pressure monitors owned by participants in a large decentralised clinical trial in hypertension: the Treatment In Morning versus Evening (TIME) study

Various home blood pressure monitors (HBPMs) are available to the public for purchase but only some are validated against standardised protocols. This study aimed to assess whether HBPMs owned by participants taking part in a clinical trial were validated models. The TIME study is a decentralised randomised trial investigating the effect of antihypertensive medication dosing time on cardiovascular outcomes in adults with hypertension. No HBPMs were provided to participants in this trial but patients were asked to report if they already owned one. We identified the model of HBPM reported by participants, then cross-referenced this against lists of validated HBPMs produced by dabl Educational Trust and the British and Irish Hypertension Society (BIHS). Of 21,104 participants, 10,464 (49.6%) reported their model of HBPM. 7464 (71.3%) of these participants owned a monitor that could be identified from the participants’ entry. Of these, 6066 (81.3%) participants owned a monitor listed as validated by either dabl (n = 5903) or BIHS (n = 5491). Some were listed as validated by both. 1398 (18.7%) participants owned an identifiable HBPM that lacked clear evidence of validation. 6963 (93.3%) participants owned an upper arm HBPM and 501 (6.7%) owned a wrist HBPM. Validated HBPMs had a higher median online retail price of £45.00 compared to £20.00 for HBPMs lacking clear evidence of validation. A significant number of participants own HBPMs lacking evidence of validation.

Basic technology and proper usage of home health monitoring devices

Home health monitoring devices are consumer-grade devices that help to monitor the health of individuals at home. These devices are usually low-cost and easily procurable, and they can be operated by patients or their caretakers with minimal training. However, improper usage of these devices may provide erroneous results, which can lead to an unnecessary hospital visit or teleconsultation. In this article, we discuss the basic technology and proper usage of some of these devices, namely automatic blood pressure monitors, blood glucose monitors, body fat monitors, pulse oximeters, electrocardiographs, digital thermometers, and infrared thermometers. This brief document intends to help primary health care professionals and their patients use these devices.

PP309 Accuracy Of Automated Wrist Blood Pressure Monitors: Systematic Review

IntroductionThe use of automated blood pressure monitors is recommended by current guidelines; however, the accuracy of the device must be validated according to standardized protocols. Wrist blood pressure monitors have been undergoing technical improvements; nonetheless, their reliability is not unanimously recognized. No systematic review to date has analyzed the accuracy of wrist blood pressure monitors according to standardized protocols. This study aims to summarize the evidence on the accuracy of wrist blood pressure monitors in adults.MethodsThree databases (PubMed, Scopus and SciELO) were searched on 9 September 2019. The PICO (Patient, Intervention, Comparison and Outcome) strategy was used to outline the research question: Do automated wrist blood pressure monitors have accuracy equivalent to mercury sphygmomanometers in adults? Validation studies of wrist blood pressure monitors were included. Two reviewers independently screened abstracts and full texts. Summary data was extracted for each device, including mean difference of systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the monitor and the mercury sphygmomanometer.ResultsThe review identified twenty-nine validation studies. Most of them were developed in China (44.82%), followed by Italy (20.68%). The most commonly used validation protocol was from the British Society of Hypertension. The mean difference between the devices and the mercury sphygmomanometers was 0.47 (±5.75) mmHg for SBP and 0.17 (±4.75) mmHg for DBP. The percentage of wrist blood pressure monitors that passed validation protocols was 93.1.ConclusionsMost automated wrist blood pressure monitors showed accuracy equivalent to the reference standard for blood pressure measurement, with mean differences less than 0.5 mmHg for SBP and 0.2 for DBP. This evidence supports the recommendation to adopt this technology for the measurement of blood pressure in adults. However, wrist blood pressure monitors have patient positioning specificities, which, if not followed, may lead to measurement errors. Therefore, the adoption of these monitors should consider not only their accuracy, but also aspects of patient use and preferences.