Measurement Adherence in the Blood Pressure Self-Measurement Room

Background:Patients with hypertension or receiving blood pressure (BP)-lowering treatment are often required to self-measure their BP in a dedicated self-measurement room before consultation. Current praxis does not guarantee valid measurements, possibly leading to misdiagnoses or inappropriate antihypertensive medication. The aim of this study was to investigate patients' ability to correctly self-report and follow recommendations.Patients and Methods:We used a context-aware system to gather information on BP measurements and relevant context parameters. Patients were not informed that the system automatically collected behavior data and were instructed to self-report their measurements on a paper sheet as usual. We then compared the automatically recorded data with the self-reported data in order to detect any nonadherent reporting behavior. Also, we investigated the patients' ability to adhere to the measurement recommendations.Results:We found that (1) a third of all 113 participating patients failed to self-report measured BP data correctly and (2) none of the 642 measurements obtained adhered fully to the recommendations.Conclusions:Results indicate that context-aware technology may be useful for accurately modeling aspects of nonadherent patient behavior. This may be used to inform staff of the validity of the measurement and pinpoint patients in need of additional training or to design better aids to assist the patients. The developed system is generally applicable to other self-measurement environments, including the home setting and remote outpatient clinics, as it is built using telemedicine technology and thus well suited for remote monitoring and diagnosis.