Most physicians learn how to measure blood pressure while in medical school, but they never revisit that training during their professional life, which could lead to misdiagnoses, according to two major associations.
The American Medical Association and the American Heart Association on Monday launched a 30-minute online course to train healthcare professionals on measuring blood pressure based on 2017 clinical guidelines for preventing, detecting, evaluating and managing adult hypertension.
"Hypertension is a leading risk factor for heart attacks, strokes and preventable death in the U.S. Inaccurate blood pressure readings can lead to diagnosis errors, which means getting an accurate reading is vital to treating the condition," AMA President Dr. Patrice Harris said. "To support physicians and care teams, we will continue working with healthcare organizations on implementing quality improvement efforts that enhance the standard of care and safety for the patients they serve."
To test the course's effectiveness, the AMA and AHA have partnered with Advocate Aurora Health, the University of Pennsylvania, the University of Alabama at Birmingham, and CVS' MinuteClinic chain to see if it meets their clinical staff's training needs.
"We have already started to develop a hypertension disease team that is benefiting from this experience, with plans to integrate the training module into routine clinical practice," said Dr. Jordana Cohen, assistant professor of medicine and epidemiology in the Renal-Electrolyte and Hypertension Division and Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania.
Harris said the module was developed after an AMA-AHA survey of more than 2,000 healthcare professionals showed they were not receiving regular blood pressure measurement training.
Half of the physicians and physician assistants reported never receiving blood pressure measuring retraining after their initial training in school while one-third of nurses and a quarter of medical assistants were not re-trained.
That makes it more likely that inaccurate measurements are being taken during patient visits, which could lead to misdiagnosis and inappropriate treatment, Harris said.
Only 1 in 10 medical assistants were able to correctly answer all six questions given to them on best practices for blood pressure measurement, according to the survey.
As many as 41% of blood pressure measurements taken across all medical practices were probably less than 100% accurate, the professionals surveyed said. Six in 10 clinicians attributed inaccurate readings to human error while only 2 in 10 thought they were caused by faulty equipment.
But the survey found wide support for retraining. Half of medical assistants and three-quarters of nurses, physician assistants, primary-care physicians and pharmacists reported blood pressure measurement refresher training was not required but should be a part of regular part of their continuing medical education.
The most recent hypertension guidelines suggest that healthcare professionals be retrained on measuring blood pressure every six to 12 months.
Both organizations hope the new course will create a new standard for clinicians, Harris said.
Preliminary data from an ongoing study has found only 23% of healthcare professionals are able to perform most steps needed to achieve an accurate blood pressure reading.
"Generally speaking, high blood pressure is underdiagnosed, and improved measurement by healthcare professionals is one step toward enhancing care of those with high blood pressure," Harris said.