Experiences of patients and professionals participating in the HITS home blood pressure telemonitoring trial: a qualitative study
Open accessAbstract
Objectives: To explore the experiences of patients and professionals taking part in a randomised controlled trial (RCT) of remote blood pressure (BP) telemonitoring supported by primary care. To identify factors facilitating or hindering the effectiveness of the intervention and those likely to influence its potential translation to routine practice. Design: Qualitative study adopting a qualitative descriptive approach. Participants: 25 patients, 11 nurses and 9 doctors who were participating in an RCT of BP telemonitoring. A maximum variation sample of patients from within the trial based on age, sex and deprivation status of the practice was sought. Setting: 6 primary care practices in Scotland. Method: Data were collected via taped semistructured interviews. Initial thematic analysis was inductive. Multiple strategies were employed to ensure that the analysis was credible and trustworthy. Results: Prior to the trial, both patients and professionals were reluctant to increase the medication based on single BP measurements taken in the surgery. BP measurements based on multiple electronic readings were perceived as more accurate as a basis for action. Patients using telemonitoring became more engaged in the clinical management of their condition. Professionals reported that telemonitoring challenged existing roles and work practices and increased workload. Lack of integration of telemonitoring data with the electronic health record was perceived as a drawback. Conclusions: BP telemonitoring in a usual care setting can provide a trusted basis for medication management and improved BP control. It increases patients’ engagement in the management of their condition, but supporting telemetry and greater patient engagement can increase professional workloads and demand changes in service organisation. Successful service design in practice would have to take account of how additional roles and responsibilities could be realigned with existing work and data management practices. The embedded qualitative study was included in the protocol for the HITS trial registered with ISRCTN no. 72614272.
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Some felt empowered by these interventions to use the health care system more effectively.
“Some felt empowered by these interventions to use the health care system more effectively [76,77].”
Qualitative explorations of some asthma and COPD interventions suggested that daily professional monitoring of telemonitored parameters (such as pulse oximetry or symptom scores) could engender reliance on professionals rather than supporting self-management.
“However, qualitative explorations of some asthma and COPD interventions suggested that daily professional monitoring of telemonitored parameters (such as pulse oximetry or symptom scores) could engender reliance on professionals rather than supporting self-management [11,76,78,79].”
Qualitative methodologies have highlighted that users valued convenience, a sense of being "watched over", and finding the telemonitoring data reassuring.
“Such questions have been addressed using qualitative methodologies [75], which have highlighted that users valued convenience [76], a sense of being “watched over” [11,77], and finding the telemonitoring data reassuring [78].”
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Cites
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995 · see citing works
The challenge of complexity in health care
Plsek, P. E., & Greenhalgh, T. (2001) · BMJ · doi:10.1136/bmj.323.7313.625 · Cited by 2,578 · see citing works
Interpretive description: A noncategorical qualitative alternative for developing nursing knowledge
Thorne, S. E., Kirkham, S. R., & MacDonald‐Emes, J. (1997) · Research in Nursing & Health · doi:10.1002/(sici)1098-240x(199704)20:2 · Cited by 1,730 · see citing works
Bobrie, G. (2004) · JAMA · doi:10.1001/jama.291.11.1342 · Cited by 842 · see citing works
Mair, F. S., May, C., O’Donnell, C., Finch, T., Sullivan, F., & Murray, E. (2012) · Bulletin of the World Health Organization · doi:10.2471/blt.11.099424 · Cited by 553 · see citing works
McManus, R., Mant, J., Bray, E., Holder, R., Jones, M. I., Greenfield, S., Kaambwa, B., Banting, M., Bryan, S., Little, P., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60964-6 · Cited by 552 · see citing works
Okonofua, E. C., Simpson, K. N., Jesri, A., Rehman, S. U., Durkalski, V. L., & Egan, B. M. (2006) · Hypertension · doi:10.1161/01.hyp.0000200702.76436.4b · Cited by 527 · see citing works
Pickering, T., Miller, N., Ogedegbe, G., Krakoff, L., Artinian, N., & Goff, D. (2008) · HYPERTENSION · doi:10.1161/hypertensionaha.107.189010 · Cited by 460 · see citing works
A rational model for assessing and evaluating complex interventions in health care
May, C. (2006) · BMC Health Services Research · doi:10.1186/1472-6963-6-86 · Cited by 447 · see citing works
Hodgkinson, J., Mant, J., Martin, U., Guo, B., Hobbs, F. D. R., Deeks, J. J., Heneghan, C., Roberts, N., & McManus, R. J. (2011) · BMJ · doi:10.1136/bmj.d3621 · Cited by 370 · see citing works
Home Blood Pressure Management and Improved Blood Pressure Control
Bosworth, H. B. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.276 · Cited by 253 · see citing works
Bray, E. P., Holder, R., Mant, J., & McManus, R. J. (2010) · Annals of Medicine · doi:10.3109/07853890.2010.489567 · Cited by 245 · see citing works
McKinstry, B., Hanley, J., Wild, S., Pagliari, C., Paterson, M., Lewis, S., Sheikh, A., Krishan, A., Stoddart, A., & Padfield, P. (2013) · BMJ · doi:10.1136/bmj.f3030 · Cited by 199 · see citing works
Self-citationUnderstanding the Normalization of Telemedicine Services through Qualitative Evaluation: Table 1
May, C., Harrison, R., Finch, T., MacFarlane, A., Mair, F., & Wallace, P. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1145 · Cited by 155 · see citing works
Fairbrother, P., Ure, J., Hanley, J., McCloughan, L. B., Denvir, M. A., Sheikh, A., McKinstry, B., & The Telescot programme team (2013) · Journal of Clinical Nursing · doi:10.1111/jocn.12137 · Cited by 140 · see citing works
Self-citationPiloting tele-monitoring in COPD: a mixed methods exploration of issues in design and implementation
Ure, J., Pinnock, H., Hanley, J., Kidd, G., Smith, E. M., Tarling, A., Pagliari, C., Sheikh, A., MacNee, W., & McKinstry, B. (2011) · Primary Care Respiratory Journal · doi:10.4104/pcrj.2011.00065 · Cited by 106 · see citing works
Self-citationJones, M. I., Greenfield, S., Bray, E., Baral-Grant, S., Hobbs, F. R. R., Holder, R., Little, P., Mant, J., Virdee, S. K., Williams, B., et al. (2012) · The British journal of general practice : the journal of the Royal College of General Practitioners · doi:10.3399/bjgp12x625201 · Cited by 95 · see citing works
The Quality and Outcomes Framework
Simon, C. (2008) · InnovAiT Education and inspiration for general practice · doi:10.1093/innovait/inn023 · Cited by 75 · see citing works
Stoddart, A., Hanley, J., Wild, S. H., Pagliari, C., Paterson, M., Lewis, S. C., Sheikh, A., Krishan, A., Padfield, P. L., & McKinstry, B. (2013) · BMJ Open · doi:10.1136/bmjopen-2013-002681 · Cited by 71 · see citing works
Self-citationSelf measured and ambulatory blood pressure in assessing the ‘white-coat’ phenomenon
Parati, G., & Stergiou, G. S. (2003) · Journal of Hypertension · doi:10.1097/00004872-200304000-00005 · Cited by 50 · see citing works
Bostock, Y., Hanley, J., McGown, D., Pinnock, H., Padfield, P., & McKinstry, B. (2009) · Primary Health Care Research & Development · doi:10.1017/s1463423609990107 · Cited by 45 · see citing works
Self-citationAbdullah, A., & Othman, S. (2011) · BMC Family Practice · doi:10.1186/1471-2296-12-143 · Cited by 45 · see citing works
Stroke patients' perceptions of home blood pressure monitoring: a qualitative study.
Ovaisi, S., Ibison, J., Leontowitsch, M., Cloud, G., Oakeshott, P., & Kerry, S. (2011) · The British journal of general practice : the journal of the Royal College of General Practitioners · doi:10.3399/bjgp11x593893 · Cited by 39 · see citing works
Lambert-Kerzner, A., Havranek, E. P., Plomondon, M., Albright, K., Moore, A., Gryniewicz, K., Magid, D., & Ho, P. (2010) · Circulation. Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.110.949800 · Cited by 26 · see citing works
Feasibility of blood pressure telemonitoring in patients with poor blood pressure control
McCant, F., McKoy, G., Grubber, J. M., Olsen, M. K., Oddone, E. Ž., Powers, B. J., & Bosworth, H. B. (2009) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2009.090202 · Cited by 25 · see citing works
Self-Monitoring of Blood Pressure
Pickering, T. G. (2001) · Humana Press eBooks · doi:10.1007/978-1-59259-004-9_1 · Cited by 17 · see citing works
Physiological Aspects of Noninvasive Ambulatory Blood Pressure Monitoring
Pickering, T. (1990) · Physiology · doi:10.1152/physiologyonline.1990.5.4.176 · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [2]Barlow J Hendy J Adopting integrated mainstream telecare services: lessons from the UK. Eurohealth 2009; 15: 8– 9
Cited by
Sorted by citations
Interactive telemedicine: effects on professional practice and health care outcomes
Flodgren, G., Rachas, A., Farmer, A. J., Inzitari, M., & Shepperd, S. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002098.pub2 · Cited by 806 · see citing works
Hanlon, P., Daines, L., Campbell, C., McKinstry, B., Weller, D., & Pinnock, H. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6688 · Cited by 499 · see citing works
“Some felt empowered by these interventions to use the health care system more effectively [76,77].”
Self-citationJacob, C., Sanchez-Vazquez, A., & Ivory, C. (2020) · JMIR mHealth and uHealth · doi:10.2196/15935 · Cited by 292 · see citing works
Palacholla, R. S., Fischer, N., Coleman, A., Agboola, S., Kirley, K., Felsted, J., Katz, C., Lloyd, S., & Jethwani, K. (2019) · JMIR Cardio · doi:10.2196/11951 · Cited by 127 · see citing works
The Role of Telemedicine in Hypertension Management: Focus on Blood Pressure Telemonitoring
Omboni, S., & Ferrari, R. (2015) · Current Hypertension Reports · doi:10.1007/s11906-015-0535-3 · Cited by 140 · see citing works
Fletcher, B. R., Hinton, L., Hartmann-Boyce, J., Roberts, N. W., Bobrovitz, N., & McManus, R. J. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.08.026 · Cited by 121 · see citing works
“Following removal of duplicates and title and abstract screening, 45 full text articles were assessed and 12 articles met the selection criteria [15-26].”
MethodGuise, V., Anderson, J., & Wiig, S. (2014) · BMC Health Services Research · doi:10.1186/s12913-014-0588-z · Cited by 102 · see citing works
Telemonitoring at scale for hypertension in primary care: An implementation study
Hammersley, V., Parker, R., Paterson, M., Hanley, J., Pinnock, H., Padfield, P., Stoddart, A., Park, H. G., Sheikh, A., & McKinstry, B. (2020) · PLOS Medicine · doi:10.1371/journal.pmed.1003124 · Cited by 61 · see citing works
“This is in part 6 due to poor adherence to medication [3], but also reluctance on the 7 part of clinicians to intensify therapy [4] and patients to accept 8 intensified therapy [5].”
Self-citationQualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes
Hanley, J., Fairbrother, P., McCloughan, L., Pagliari, C., Paterson, M., Pinnock, H., Sheikh, A., Wild, S., & McKinstry, B. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008896 · Cited by 43 · see citing works
Self-citationthe CLIP Working Group, Nathan, H. L., Boene, H., Munguambe, K., Sevene, E., Akeju, D., Adetoro, O. O., Charanthimath, U., Bellad, M. B., de Greeff, A., et al. (2018) · Reproductive Health · doi:10.1186/s12978-017-0450-y · Cited by 41 · see citing works
Sharing patient-generated data with healthcare providers: findings from a 2019 national survey
Turner, K., Jo, A., Wei, G., Tabriz, A. A., Clary, A., & Jim, H. S. L. (2021) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa272 · Cited by 33 · see citing works
- Authors
- Hanley, J., Ure, J., Pagliari, C., Sheikh, A., & McKinstry, B.
- Affiliations
- Edinburgh Napier University (GB)
- University of Edinburgh (GB)
- Corresponding author
- Hanley, Janet
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2013
- Volume
- 3
- Issue
- 5
- Pages
- e002671
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC3657666
- OpenAlex
- W2155829918
- Cited by
- 68
- References
- 28
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 5 · 2020: 6 · 2019: 8 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 3
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research Output (Edinburgh Napier University) (submittedVersion, cc-by-nc)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by-nc)
- Funders
- Bupa Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- home blood pressure telemonitoring, hypertension, patient experience, professional experience, primary care, patient engagement, medication management, workload, electronic health records
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