Feasibility, reliability and safety of self-assessed orthostatic blood pressure at home.
Age Ageing
; 51(7)2022 07 01.
Article
en En
| MEDLINE
| ID: mdl-35776671
ABSTRACT
BACKGROUND:
A postural blood pressure assessment is required to diagnose Orthostatic Hypotension. With increasing remote consultations, alternative methods of performing postural blood pressure assessment are required.OBJECTIVE:
Determine whether postural blood pressure measurement at home, without a clinician, is reliable, feasible and safe.DESIGN:
Service improvement project within a falls and syncope service in Northeast England.SUBJECTS:
Eligibility criteria aged ≥60 years; postural blood pressure measurement is indicated and is physically and cognitively able to perform. Exclusion criteria nursing home residents, attending clinic in person.METHODS:
Postural blood pressure measurements were performed in patients' homes under clinical observation. Patient-led assessments were performed independent of the clinician, following written guidance. This was followed by a clinical-led assessment after 10-minute supine rest.OUTCOMES:
Agreement between patient and clinician derived postural blood pressure values and diagnosis of Orthostatic Hypotension; intervention safety, feasibility and acceptability.RESULTS:
Twenty-eight patients were eligible and 25 participated (mean age 75, median Clinical Frailty Score five).There was 95% agreement (Cohen's kappa 0.90 (0.70, 1.00)) between patient and clinician derived readings to diagnose orthostatic hypotension.Postural systolic blood pressure drop correlated strongly (r = 0.80), with patient derived readings overestimating by 1 (-6, 3) mmHg. Limits of agreement, determined via Bland Altman analysis, were +17 and -20 mmHg, greater than pre-determined maximum clinically important difference (±5 mmHg).Twenty participants performed valid postural blood pressure assessments without clinical assistance.CONCLUSIONS:
Patient-led postural blood pressure assessment at home is a reliable, safe and acceptable method for diagnosing Orthostatic Hypotension.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Hipotensión Ortostática
Tipo de estudio:
Diagnostic_studies
/
Guideline
Límite:
Aged
/
Humans
Idioma:
En
Revista:
Age Ageing
Año:
2022
Tipo del documento:
Article
País de afiliación:
Reino Unido