Feasibility of home blood pressure screening in the paediatric outpatient clinic setting.

Abstract

The aim of this study was to evaluate the acceptability and feasibility of home-based blood pressure (BP) screening in a group of paediatric patients with known elevated risk of developing hypertension. Cross-sectional study. Specialist outpatient clinic and patient homes. 52 children and adolescents living with neurofibromatosis type 1. Clinic BP measured thrice manually and once via an automated device; home BP measured daily with the same device for 3 days. Acceptability and feasibility were assessed with a Children's Anxiety Meter-State score, the comparability of home and clinic BPs, a parental survey, assessment of costs and the device return rate. Home systolic BP and diastolic BP were statistically similar to both clinic manual (95% CI -4.78 to 0.13; -4.80 to 0.93) and automatic BPs (95% CI -4.44 to 2.08; -0.54 to 5.52). Anxiety scores (95% CI -0.57 to 0.35) were also similar between settings. Participants and their families reported that home BP measurement was easy, took ~10 min and minimally interrupted family life. Families also largely preferred home BP screening (73% 'yes', 23% 'not sure', 3% 'no'), and 90% returned their devices. Families reported substantial costs in attending clinic, which could be reduced with access to this home BP programme. Home BP screening was acceptable and feasible, with home BPs comparable to clinic measurements, no associated anxiety and preferred by families. Telehealth with home BP screening is a viable alternative to in-person appointments, which could reduce individual costs, and foster greater equity of care and access to health services.