{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:21:30Z","timestamp":1790846490610,"version":"4.1.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Determine whether postural blood pressure measurement at home, without a clinician, is reliable, feasible and safe.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Service improvement project within a falls and syncope service in Northeast England.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>Eligibility criteria: aged \u226560 years; postural blood pressure measurement is indicated and is physically and cognitively able to perform.<\/jats:p>\n                  <jats:p>Exclusion criteria: nursing home residents, attending clinic in person.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Postural blood pressure measurements were performed in patients\u2019 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Agreement between patient and clinician derived postural blood pressure values and diagnosis of Orthostatic Hypotension; intervention safety, feasibility and acceptability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-eight patients were eligible and 25 participated (mean age 75, median Clinical Frailty Score five).<\/jats:p>\n                  <jats:p>There was 95% agreement (Cohen\u2019s kappa 0.90 (0.70, 1.00)) between patient and clinician derived readings to diagnose orthostatic hypotension.<\/jats:p>\n                  <jats:p>Postural systolic blood pressure drop correlated strongly (r\u2009=\u20090.80), with patient derived readings overestimating by 1 (\u22126, 3) mmHg. Limits of agreement, determined via Bland Altman analysis, were +17 and \u221220 mmHg, greater than pre-determined maximum clinically important difference (\u00b15\u00a0mmHg).<\/jats:p>\n                  <jats:p>Twenty participants performed valid postural blood pressure assessments without clinical assistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patient-led postural blood pressure assessment at home is a reliable, safe and acceptable method for diagnosing Orthostatic Hypotension.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afac153","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T15:56:32Z","timestamp":1656690992000},"source":"Crossref","is-referenced-by-count":12,"title":["Feasibility, reliability and safety of self-assessed orthostatic blood pressure at home"],"prefix":"10.1093","volume":"51","author":[{"given":"Jake R","family":"Gibbon","sequence":"first","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve W","family":"Parry","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK"},{"name":"Population Health Science Institute , Newcastle University, Newcastle upon Tyne NE2 4AX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miles D","family":"Witham","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK"},{"name":"AGE Research Group , NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Yarnall","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK"},{"name":"Brain and Movement Research Group , Translational and Clinical Research Institute, Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Frith","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne NE1 4LP, UK"},{"name":"Population Health Science Institute , Newcastle University, Newcastle upon Tyne NE2 4AX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"key":"2022070115562268700_ref1","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","article-title":"2018 ESC guidelines for the diagnosis and management of syncope","volume":"39","author":"Brignole","year":"2018","journal-title":"Eur Heart J"},{"key":"2022070115562268700_ref2","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1111\/j.1532-5415.2010.03234.x","article-title":"Summary of the updated American Geriatrics Society\/British Geriatrics Society clinical practice guideline for prevention of falls in older persons","volume":"59","author":"Drootin","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"2022070115562268700_ref3"},{"key":"2022070115562268700_ref4","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1136\/dtb.2020.000056","article-title":"Orthostatic hypotension: a pragmatic guide to 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