{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:03:12Z","timestamp":1788998592032,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Nearly half of American adults live with high blood pressure, of whom three\u2010quarters do not have their blood pressure under adequate control. Many challenges exist in assessing blood pressure control, including in\u2010clinic measurement biases and physiologic variability, limiting the ability to appropriately guide therapeutic changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>This study's objective was to compare blood pressure (BP) variability in\u2010clinic and at\u2010home using a BP monitoring app.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, observational study compared in\u2010clinic BP measurements to at\u2010home BP measurements recorded via a mobile application from April 2024 to May 2025. BP variability was assessed, comparing standard deviations (SD), control status (adequately controlled: systolic BP\u2009&lt;\u2009140\u2009mmHg and diastolic BP\u2009&lt;\u200990\u2009mmHg), and both within\u2010day and within\u2010week timeframe fluctuations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 304 patients with sufficient in\u2010clinic data, the mean SD value for in\u2010clinic systolic BP was 12.6\u2009mmHg. Comparing at\u2010home readings 2, 4, and 6 weeks before an in\u2010clinic appointment for 207, 229, and 243 patients with sufficient data, 71.5%, 72.1%, and 72.8% of in\u2010clinic measurements differed by more than 5\u2009mmHg from average at\u2010home systolic BP, and 30.1%, 29.8%, and 29.8% indicated a different hypertension control status, respectively. For patients with at\u2010home readings, the mean systolic BP SD for 288 patients within the same day was 8.8\u2009mmHg. Over 2, 4, and 6 week timeframes, mean SD increased to 10.5, 10.9, and 11.1\u2009mmHg for 322, 329, and 336 patients with sufficient readings, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reliance on single in\u2010clinic BP measurements for hypertension management can be inaccurate due to significant variability over time. In addition to impacting treatment decisions, this may impact HEDIS metrics and Medicare Advantage Star ratings, which heavily influence healthcare revenue and quality perception. Findings indicate at\u2010home BP monitoring can result in a meaningfully different BP control rate, emphasizing a role for at\u2010home monitoring to enhance BP measurement reliability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70299","type":"journal-article","created":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T07:30:06Z","timestamp":1762068606000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Blood Pressure Variability Between In\u2010Clinic and At\u2010Home Measurements: Implications for Care Quality Assessment"],"prefix":"10.1111","volume":"31","author":[{"given":"L. J.","family":"Zimmermann","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Data &amp; Actuarial Science, Nuna, Inc. San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Pallok","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Advanced Analytics, Rush Health Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Ansell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. E.","family":"Niehaus","sequence":"additional","affiliation":[{"name":"Data &amp; Actuarial Science, Nuna, Inc. San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,2]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"\u201cHigh Blood Pressure Facts \u201d Centers for Disease Control and Prevention 15 May 2024 www.cdc.gov\/high-blood-pressure\/data-research\/facts-stats\/?CDC_AAref_Val=https%3A%2F%2Fwww.cdc.gov%2Fbloodpressure%2Ffacts.htm."},{"key":"e_1_2_7_3_1","unstructured":"Healthcare Effectiveness Data and Information Set (HEDIS) Healthcare Effectiveness Data and Information Set (HEDIS) \u2010 Healthy People 2030 odphp.health.gov\/healthypeople\/objectives-and-data\/data-sources-and-methods\/data-sources\/healthcare-effectiveness-data-and-information-set-hedis accessed 22 Jan. 2025."},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","unstructured":"P. K.Whelton R. M.Carey W. S.Aronow et al.2017ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the Prevention Detection Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 71 no. 6 (2017): e13\u2013e115 https:\/\/doi.org\/10.1161\/HYP.0000000000000065.","DOI":"10.1161\/HYP.0000000000000076"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2007.20"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(99)00057-6"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003994"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.189010"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2010.194"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpae151"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07400-z"},{"key":"e_1_2_7_12_1","unstructured":"National Committee for Quality Assurance (2021 August 17) Blood Pressure HEDIS Results During COVID. NCQA Blog https:\/\/www.ncqa.org\/blog\/blood-pressure-hedis-results-during-covid\/."},{"key":"e_1_2_7_13_1","unstructured":"Home Blood Pressure Monitoring American Heart Association https:\/\/www.heart.org\/en\/health-topics\/high-blood-pressure\/understanding-blood-pressure-readings\/monitoring-your-blood-pressure-at-home."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_2_7_15_1","unstructured":"HEDIS Measurement Year 2024 Technical Specifications NCQA https:\/\/www.ncqa.org\/hedis\/measures\/."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-022-01706-4"},{"key":"e_1_2_7_17_1","unstructured":"HEDIS Measurement Year 2024 Technical Specifications NCQA https:\/\/www.ncqa.org\/hedis\/measures\/."},{"key":"e_1_2_7_18_1","unstructured":"Medicare Update CVS Health Corporation SEC filing 25 May 2023 https:\/\/www.sec.gov\/ix?doc=\/Archives\/edgar\/data\/0000064803\/000006480323000021\/cvs-20230525_d2.htm accessed 12 Mar. 2025."}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70299","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.70299","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T06:34:19Z","timestamp":1776148459000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.70299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,2]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/jep.70299"],"URL":"https:\/\/doi.org\/10.1111\/jep.70299","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,2]]},"assertion":[{"value":"2025-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70299"}}