Can Self-Management of Blood Pressure Reduce Costs?

To me, it is not surprising that a recent study in the medical journal The Lancet (link to abstract) showed better control of hypertension when people actively kept tabs on their blood pressure outside of the office.  Although not the purpose of the study, there is also a monetary benefit to this practice if you have hypertension, and maybe even if you don’t . . .

Checking blood pressure measurements at home can reduce your medical costs.

Home blood pressure monitors are now widely available, relatively easy to use, and are not very expensive. 

So, how might that little machine save you money?

Checking your blood pressure periodically can help you possibly avoid the additional costs of unnecessary medication.  Normal home readings might prove that you don’t have high blood pressure in the first place.  Some people can prevent needless treatment for “white coat hypertension” (blood pressure that is high only in the doctor’s office).  People who do require medications can sometimes avoid new drugs or higher dosages prompted by one unusually high measurement at the office.

You might also be able to avoid extra office visits.  I know that I often allow longer periods between recheck visits if I know that the person is monitoring their blood pressure at home.  At times, your doctor might even be willing to make medication adjustments by phone based on outside readings, rather than insisting that you come in for a meeting.

So, here are a few tips that may very well pay off . . .

  • Bring your blood pressure monitor to an office visit once or twice yearly to confirm accuracy.  It also gives your doctor confidence that you get dependable results.
  • Be sure to check your blood pressure a few times before each office visit and record the readings for review.
  • During a follow-up visit, ask if your doctor is comfortable providing a year of medication refills if you vow to monitor your blood pressure and call with results quarterly.
  • When visiting your doctor for a different reason, provide your home measurements and ask if he or she will extend your refills out further.
  • If one of your antihypertensive medications is adjusted, call the office with results–you might be able to avoid an immediate follow-up visit.

Although some situations require especially close attention, many people with high blood pressure can realize significant benefits from this simple practice.

Better care and reduced costs.  What’s not to like about that?

Stephen Meyers, MD

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2 Comments

Filed under High Blood Pressure

2 responses to “Can Self-Management of Blood Pressure Reduce Costs?

  1. Some good advice there. I wonder how many practices in the UK have active systems to support incorporation of patient-recorded BP readings into notes.
    Thanks,
    Anne Marie

    • MedSavingsDoc

      Yes, in a perfect world mobile monitoring of blood pressure with automatic upload into the electronic health record would be fantastic–both for quality and cost of care. The technology is available, but I assume that there is no universally-accepted protocol for information transfer. Solutions are also usually propietary and incompatible. If the next iPhone could measure blood pressure, EHR vendors would likely line up to integrate with it (are you listening Steve Jobs?).

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