Free Blood Pressure Monitors Cut Heart-Failure Hospital Admissions
Donna Moser was concerned.
As a nurse in the heart failure clinic at Einstein Medical Center Philadelphia, she often saw patients with high blood pressure readings.
But sometimes the reading wasn’t accurate because the patients had rushed in without eating breakfast or taking their medication. Without accurate information, it was difficult to find the right dose of medications to keep blood pressure under control.
For heart failure patients, higher blood pressure increased the risk of fluid buildup and breathing problems. Some ended up in the hospital every couple of months.
Moser concluded that to prevent these expensive and physically debilitating episodes, her patients needed a cheap, simple tool – an automated blood pressure monitor to use at home.
But many patients were on Medicaid, and most plans didn’t cover the automated model, which is much easier to use than the older, manual type. So Moser got grant money to provide the monitors for free.
Hospital Admissions Reduced by Half
A project she initiated to provide automated home monitors cut hospital admissions for any cause in half for the first group of 59 patients. Moser recently presented a talk about the project, which began in early 2021, at a meeting of the American Association of Heart Failure Nurses.
“Simple and inexpensive interventions can make a big impact in changing the course of a chronic disease such as heart failure,” says Behnam Bozorgnia, MD, Director of Heart Failure at Einstein Medical Center Philadelphia. “Closely monitoring blood pressure of heart failure patients in the comfort of home certainly meets the criteria.”
Patients reported 100% satisfaction with the program, Moser says, “because everyone really, really appreciated receiving this gift that could empower them to stay well.”
Tonya Trowell-West received her home monitor last winter after a heart-failure diagnosis and triple bypass surgery and has used it regularly since. The readings have helped her care team find the right dose of medications to stabilize her blood pressure at a lower level.
“I would say that it’s a great program because in my situation, I couldn’t afford it and didn’t have health insurance at the time, so I’m grateful for it,” she says.
What Is Heart Failure?
Heart failure is a form of decreased heart function, Moser says.
“The heart becomes weaker over time because it’s pumping against this high resistance, hypertension, or it becomes stiffer, which means it doesn’t relax as well,” she says. Some people have both types of heart failure.
Coronary artery disease, heart attacks and high blood pressure are among the potential causes of heart failure, so controlling these conditions can help prevent it. For those who already have heart failure, lower blood pressure reduces the risk of fluid buildup that sends people to the hospital.
“Once the person has been in the hospital for their first time for heart failure, there’s a 50/50 chance they’re not going to be with us in five years,” Moser says. “So it’s a serious chronic health condition that we can help prevent by controlling blood pressure.”
Moser started handing out automated blood pressure monitors in spring 2021 with a $750 grant from Einstein’s Compassionate Care Program. She received an identical grant this year.
The program funds projects and services to support Einstein patients at the bedside and beyond. Learn more about the Compassionate Care Program.
Staff members also have contributed out of their own pockets, Moser says, because they believe in the program. So far, she has given out more than 100 monitors, costing about $30 each.
Moser gave the monitors to people referred by the heart failure team and other patients who had called her about symptoms. Most had heart failure already, but a few were at risk for it because of high blood pressure.
Easy and Cost-Effective
She gave out the machines with batteries already installed. They are easy to use – just put on the cuff and push a button. But Moser also gave instructions.
“Some patients I gave curbside instruction at the door of the Tabor Road entrance so they wouldn’t have to pay for parking,” she says.
In the six months before the project started, the 59 patients had a total of 20 hospital admissions for any cause, Moser says. In the six months afterward, they had only 10 admissions. And the admission rate kept going down over time as their blood pressure stabilized.
Moser’s next goal is to lobby government officials to make sure Medicaid always covers an automated blood pressure monitor for heart failure patients.
An automated monitor costs a bit more, Moser notes – about $25 to $35, compared with about $20 for the older models that are harder to use.
But helping people monitor their blood pressure more easily, she says, can prevent a hospital stay that costs about $15,000 for three to five days.
Prevention is especially important in the neighborhoods around Einstein Philadelphia, she says, because the African American and Hispanic populations have a higher risk of high blood pressure and heart failure.
“This is our community and this is our mission for Einstein to help our patients and give them the tools they need to stay well and live their lives.”
Learn about heart and vascular care at Einstein.