Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States Academic Article uri icon


MeSH Major

  • Accidental Falls
  • Antihypertensive Agents
  • Drug-Related Side Effects and Adverse Reactions
  • Hypertension
  • Wounds and Injuries


  • In 2015, the US Preventive Services Task Force updated their hypertension recommendations to advise that adults with elevated office blood pressure (BP) undergo out-of-office BP measurement to exclude white coat hypertension before diagnosis. Our goal was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. We enrolled 63 primary care providers into nominal group panels in which participants iteratively listed and ranked barriers to ambulatory and home BP monitoring. Top-ranked barriers to ambulatory BP monitoring were challenges in accessing testing, costs of testing, concerns about the willingness or ability of patients to successfully complete tests, and concerns about the accuracy and benefits of testing. Top-ranked barriers to home BP monitoring were concerns about compliance with the correct test protocol, accuracy of tests results, out-of-pocket costs of home BP devices, and time needed to instruct patients on home BP monitoring protocol. Efforts to increase the use of ambulatory and home BP monitoring by primary care providers in the United States should prioritize increasing the financial and personnel resources available for testing and addressing provider concerns about patients' ability to conduct high-quality tests.

publication date

  • January 2017



  • Academic Article



  • eng

PubMed Central ID

  • PMC5595651

Digital Object Identifier (DOI)

  • 10.1016/j.jash.2017.06.012

PubMed ID

  • 28734798

Additional Document Info