Impact of telemetry supported home blood pressure monitoring: experiences of patients and professionals participating in the HITS randomised controlled trial of telemetry enabled home blood pressure (BP)

Hanley, Janet; Ure, Jenny; Paterson, Mary; Wild, Sarah; Padfield, Paul; Pagliari, Claudia; McKinstry, Brian

Abstract

Aim: To explore the experiences of participants in a randomised controlled trial of telemetry supported home blood pressure monitoring
for people with hypertension in order to explain the outcomes and guide further service development.
Method: Twenty-five patients and the healthcare teams from 6 (of 20) participating practices were interviewed. Transcribed interviews
were analysed thematically with verification through partial double coding, team review, and presentation of the analysis and sections of
coded data back to participants.
Results: Doctors, nurses and patients were aware that BP measured in the surgery could be a poor indicator of usual BP and this
delayed changes to treatment. The rolling average blood pressure from telemetry enabled home monitoring, visible to both the patient
and practice, was accepted as a good indicator which should prompt changes in self care and treatment. Although patients had different
emotional reactions to home monitoring (some saying that focusing on a health risk they normally did not think about increased
anxiety, most saying that home monitoring reassured them), many provided examples of using the data to monitor their response to self
care changes such as increasing exercise, and to medication changes. They also used the data in healthcare consultations to be more
explicit in negotiating what they wanted. Healthcare professionals mostly considered home monitoring to be empowering for patients,
but shared the concern that for a few patients it may increase anxiety. Managing telehealth was challenging to practice organisation and
individual work patterns, and increased patient contacts with the practice. This was difficult to sustain using traditional face-to-face
contacts and there was increased use of telephone contacts and some experimentation with email. Some professionals questioned the
value of reaching the target BP on overall cardiovascular risk and reluctance to increase medication and resistance from patients was a
theme, although not a major one.
Conclusion: Telemetry enabled home BP measurement has a positive effect on the management of hypertension. The main enabling
factor was increased trust in a measurement taken at home and based on multiple readings. However, it was not easy for professionals to
incorporate telehealth in their usual working practices

• Presentation Conference Type: Conference Paper (published)
• Acceptance Date: May 1, 2012
• Online Publication Date: Jun 15, 2012
• Publication Date: Jun 15, 2012
• Deposit Date: Oct 23, 2018
• Publicly Available Date: Oct 23, 2018
• Journal: International Journal of Integrated Care
• Print ISSN: 1568-4156
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 4
• DOI: https://doi.org/10.5334/ijic.910
• Keywords: blood pressure monitoring, primary care,
• Public URL: http://researchrepository.napier.ac.uk/Output/1252708
• Contract Date: Oct 23, 2018