Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes
Open accessAbstract
Objectives: To explore the experiences of patients and professionals taking part in a randomised controlled trial (RCT) of blood glucose, blood pressure (BP) and weight telemonitoring in type 2 diabetes supported by primary care, and 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 an interpretive descriptive approach. Participants: 23 patients, 6 nurses and 4 doctors who were participating in a RCT of blood glucose and 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: 12 primary care practices in Scotland and England. Method: Data were collected via recorded semistructured interviews. Analysis was inductive with themes presented within an overarching thematic framework. Multiple strategies were employed to ensure that the analysis was credible and trustworthy. Results: Telemonitoring of blood glucose, BP and weight by people with type 2 diabetes was feasible. The data generated by telemonitoring supported self-care decisions and medical treatment decisions. Motivation to self-manage diet was increased by telemonitoring of blood glucose, and the ‘benign policing’ aspect of telemonitoring was considered by patients to be important. The convenience of home monitoring was very acceptable to patients although professionals had some concerns about telemonitoring increasing workload and costs. Conclusions: Telemonitoring of blood glucose, BP and weight in primary care is a promising way of improving diabetes management which would be highly acceptable to the type of patients who volunteered for this study. Trial registration number: ISRCTN71674628; Pre-results.
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The 'improved care' theme was identified in seven of nine included studies.
“The “improved care” theme was identified in seven of nine studies. [19–23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Views on communication were inconsistent across studies; some patients found communication difficult or received minimal patient/HCP contact.
“However, this view was inconsistent across studies; for example, some patients found communication difficult [25] or received minimal patient/HCP contact. [23]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Patients and healthcare professionals reported additional benefits from more individualised treatment plans resulting from telemonitoring interventions.
“Patients and HCPs reported additional benefits in having more individualised treatment plans [19, 21–23, 26] resulting from telemonitoring interventions.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
The technology acceptability and feasibility theme arose in six studies and comprised three sub-themes: convenience and acceptability, technology feasibility, and barriers of rural areas.
“This theme arose in six studies [19, 22–25, 27] and comprise the following sub-themes: (1) Convenience & Acceptability; (2) Technology feasibility; and (3) Barriers of rural areas.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
While five studies identified clear benefits of telemonitoring, some healthcare professionals highlighted potential drawbacks concerning treatments.
“Whilst five studies [19, 21–23, 26] identified clear benefits of telemonitoring, some HCPs highlighted potential drawbacks concerning treatments.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Numerous patients with diabetes actively reduced dietary sugar intake when raised blood glucose levels were identified through the telemonitoring device.
“Numerous patients with diabetes sought to actively reduce dietary sugar intake when raised blood glucose levels were identified through the telemonitoring device. [20, 23, 25]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Communication emerged as a theme in five studies.
““Communication” emerged as a theme in five studies. [21–23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Dietary alterations or improvements were a common outcome among several studies.
“Dietary alterations/improvements were a common outcome among several studies. [19, 20, 23, 25]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Another GP stated that telemonitoring interventions would not alter medication administration.
“Another GP stated that telemonitoring interventions would not alter medication administration. [23]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
A nurse in the same study felt telemonitoring led to faster treatment changes, a view shared by participants in another included study.
“However, in direct contrast, a nurse participating in the same study felt the telemonitoring intervention led to faster treatment changes; [23] a view shared by the participants of another included study. [26].”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Telemonitoring increased patients' awareness of their health, leading them to make improved lifestyle changes.
“Several patients expressed that telemonitoring increased their awareness of their health and consequently they made improved lifestyle changes. [19, 20, 23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
In three studies, participants found devices difficult to use, accentuated by generational differences, with older participants generally less confident and less able to use them.
“In three studies, [19, 23, 27] participants found devices difficult to use, which was accentuated by generational differences, with older participants generally less confident and less able to use them.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Participants considered time-saving a benefit for both HCPs and patients.
“Participants considered that time-saving was a benefit for both HCPs and patients. [23]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
Patients commonly reported enjoying not having to attend surgery so often while being more regularly monitored.
“Patients commonly reported enjoying not having to attend surgery so often whilst being more regularly monitored. [23, 24]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [23]
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- Authors
- Hanley, J., Fairbrother, P., McCloughan, L., Pagliari, C., Paterson, M., Pinnock, H., Sheikh, A., Wild, S., & McKinstry, B.
- Affiliations
- Edinburgh Napier University (GB)
- NHS Lothian (GB)
- University of Edinburgh (GB)
- Corresponding author
- Hanley, Janet
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2015-12
- Volume
- 5
- Issue
- 12
- Pages
- e008896
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4691739
- OpenAlex
- W2220086083
- Cited by
- 43
- References
- 42
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 5 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 4
- FWCI
- 4.99
- 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)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by-nc)
- Research Output (Edinburgh Napier University) (submittedVersion, cc-by-nc)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- Scottish Government
- Engineering and Physical Sciences Research Council (EP/J017728/2)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- remote patient monitoring, type 2 diabetes, blood glucose monitoring, blood pressure monitoring, weight monitoring, self-management, primary care, patient experience, health professionals' experiences, feasibility
- MeSH terms
- Adult, Aged, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, England, Female, Humans, Male, Middle Aged, Primary Health Care, Scotland, Self Care, Biomarkers, Telemedicine, Blood Pressure Monitoring, Ambulatory, Qualitative Research
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