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Learning Objective 1: 1) The learner will be able to comprehend the problem of uncontrolled high BP and its implications for the older adult.
Learning Objective 2: 2) The learner will be able to conceptualize the scientific contributions of this research to the body of knowledge on managing chronic conditions in adults.
According to the American Heart Association (AHA), 74.5 million U.S. adults have been diagnosed with high blood pressure (HBP) but only 44.1% treated were at goal. The purpose of this study is to determine the feasibility and usefulness of remote blood pressure (BP) monitoring in the older adult for effectively managing essential hypertension. Common background scientific knowledge indicates that uncontrolled HBP leads to strokes, blindness, heart disease, kidney failure, and death (Joint National Committee (JNC) VII). Among Americans treated for their first stroke, myocardial infarction, or initial diagnosis of congestive heart failure, 77%, 69% and 74% respectively, all had BP higher than 140/90 and these conditions disproportionately affect older adults. This study will use the Health Belief Model as its theoretical framework. The method for this prospective, randomized control study will sample adults 55 years and older who meet the study criteria. There will be four groups three receiving intervention. The data collection will be done over 4-6 months. The participants will have BP monitored one, two or three times per week with ‘cues to action’ reports stipulated at each measurement, or not at all. Other variables such as quality of life, medication changes, self-reported health status, and health care utilization will be tracked. The results will be analyzed using ANOVA, trend analysis and T-test. The implications of the study lies in 1) the large population that is affected by complications of persistent uncontrolled HBP; 2) the economic burden of the illness which was estimated to cost Americans $76.6 billion in 2010 (AHA); and 3) anecdotal evidence from practice that indicates increase social burden and decrease quality of life as a result of uncontrolled HBP. The outcome, in addition to informing future studies on the subject, will contribute to practice and policy guidelines for improving hypertension management.
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