Incorporation and abandonment of technologies for indirect blood pressure measurement: analysis of preferences of patients with obesity

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Detalhes
  • Tipo de apresentação: Pôster
  • Eixo temático: 2. Metodologia e resultados de estudos de ATS
  • Palavras chaves: Blood Pressure Determination; Patient Preference; obesity; Technology Assessment;
  • 1 UNIVERSIDADE FEDERAL DO CEARÁ
  • 2 Universidade Estadual do Ceará

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Introduction: The life cycle of health technologies (HT) involves a complex set of interrelated mechanisms, starting with the invention of new devices or processes and culminating in abandonment. This occurs for several reasons, which include economic factors, availability of more efficient technologies and patient preferences. Within the scope of measurement and monitoring of blood pressure (BP), countries in the northern hemisphere have been carrying out an intense qualification process, by replacing aneroid sphygmomanometers with automated monitors. In Brazil, this process progresses more slowly and faces, among other barriers, the resistance of patients accustomed to the use of manual devices, especially those with obesity, given that in this group the measurement can cause greater discomfort. This study aims to assess the preferences of obese patients with regard to the use of devices for indirect BP measurement. Methods: This study is the evaluation of a secondary outcome from a clinical trial of equivalence conducted between August 2020 and January 2021 at the clinical research unit of an university hospital. Only obese patients were included. The BP measurement technique followed the current Brazilian guidelines and it was performed alternating the auscultatory method, using a calibrated manual sphygmomanometer, and the oscillometric method, with an automated monitor for clinical use. In both situations, appropriate cuff sizes were used. The following variables included: level of discomfort, confidence, and preferred device. It was approved by an ethics committee, under number 3.464.511. Results: The study included 73 patients, with a mean age of 43.4 (± 12.1) years, and predominance of class I obesity (45.2%). The average score of discomfort with the manual device was 2.52 (± 1.3) and in the automatic, 2.26 (± 1.3), with a statistically significant difference between the means (p <0.001). No correlation was found between discomfort score and the Body Mass Index. Less discomfort was reported when using an automatic monitor (71.2%). The preference of patients was mainly focused on manual sphygmomanomers (68.4%). Conclusion: Despite reporting less discomfort when having their BP measured with automated monitors, people with obesity prefer that manual sphygmomanometers be used to measure and monitor their BP. In view of the misuse related to the practice of auscultatory measurement in Brazil and the gains verified in the transition process experienced abroad, it is appropriate to invest in health education about HT, with a focus on providing information on the accuracy and effectiveness of automated monitors validated for clinical use.

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