Improving management and effectiveness of home blood pressure monitoring: a qualitative UK primary care study

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@article{c551daad82db4da5a8f6fa8c43566ecf,
title = "Improving management and effectiveness of home blood pressure monitoring: a qualitative UK primary care study",
abstract = "BACKGROUND: Self-monitoring blood pressure (SMBP) is becoming an increasingly prevalent practice in UK primary care, yet there remains little conceptual understanding of why patients with hypertension engage in self-monitoring.AIM: To identify psychological factors or processes prompting the decision to self-monitor blood pressure.DESIGN AND SETTING: A qualitative study of patients previously participating in a survey study about SMBP from four general practices in the West Midlands.METHOD: Taped and transcribed in-depth interviews with 16 patients (6 currently monitoring, 2 used to self-monitor, and 8 had never self-monitored). Thematic analysis was undertaken.RESULTS: Three main themes emerged: 'self' and 'living with hypertension' described the emotional element of living with an asymptomatic condition; 'self-monitoring behaviour and medication' described overall views about self-monitoring, current practice, reasons for monitoring, and the impact on medication adherence; and 'the GP-patient transaction' described the power relations affecting decisions to self-monitor. Self-monitoring was performed by some as a protective tool against the fears of a silent but serious condition, whereas others self-monitor simply out of curiosity. People who self-monitored tended not to discuss this with their nurse or GP, partly due to perceiving minimal or no interest from their clinician about home monitoring, and partly due to fear of being prescribed additional medication.CONCLUSION: The decision to self-monitor appeared often to be an individual choice with no schedule or systems to integrate it with other medical care. Better recognition by clinicians that patients are self-monitoring, perhaps utilising the results in shared decision-making, might help integrate it into daily practice.",
keywords = "Primary care, Self-monitoring, Hypertension, Motivation, Qualitative",
author = "Sabrina Grant and Greenfield, {Sheila M} and Arie Nouwen and McManus, {Richard J}",
note = "{\textcopyright} British Journal of General Practice 2015.",
year = "2015",
month = nov,
doi = "10.3399/bjgp15X687433",
language = "English",
volume = "65",
pages = "e776--83",
journal = "British Journal of General Practice ",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "640",

}

RIS

TY - JOUR

T1 - Improving management and effectiveness of home blood pressure monitoring

T2 - a qualitative UK primary care study

AU - Grant, Sabrina

AU - Greenfield, Sheila M

AU - Nouwen, Arie

AU - McManus, Richard J

N1 - © British Journal of General Practice 2015.

PY - 2015/11

Y1 - 2015/11

N2 - BACKGROUND: Self-monitoring blood pressure (SMBP) is becoming an increasingly prevalent practice in UK primary care, yet there remains little conceptual understanding of why patients with hypertension engage in self-monitoring.AIM: To identify psychological factors or processes prompting the decision to self-monitor blood pressure.DESIGN AND SETTING: A qualitative study of patients previously participating in a survey study about SMBP from four general practices in the West Midlands.METHOD: Taped and transcribed in-depth interviews with 16 patients (6 currently monitoring, 2 used to self-monitor, and 8 had never self-monitored). Thematic analysis was undertaken.RESULTS: Three main themes emerged: 'self' and 'living with hypertension' described the emotional element of living with an asymptomatic condition; 'self-monitoring behaviour and medication' described overall views about self-monitoring, current practice, reasons for monitoring, and the impact on medication adherence; and 'the GP-patient transaction' described the power relations affecting decisions to self-monitor. Self-monitoring was performed by some as a protective tool against the fears of a silent but serious condition, whereas others self-monitor simply out of curiosity. People who self-monitored tended not to discuss this with their nurse or GP, partly due to perceiving minimal or no interest from their clinician about home monitoring, and partly due to fear of being prescribed additional medication.CONCLUSION: The decision to self-monitor appeared often to be an individual choice with no schedule or systems to integrate it with other medical care. Better recognition by clinicians that patients are self-monitoring, perhaps utilising the results in shared decision-making, might help integrate it into daily practice.

AB - BACKGROUND: Self-monitoring blood pressure (SMBP) is becoming an increasingly prevalent practice in UK primary care, yet there remains little conceptual understanding of why patients with hypertension engage in self-monitoring.AIM: To identify psychological factors or processes prompting the decision to self-monitor blood pressure.DESIGN AND SETTING: A qualitative study of patients previously participating in a survey study about SMBP from four general practices in the West Midlands.METHOD: Taped and transcribed in-depth interviews with 16 patients (6 currently monitoring, 2 used to self-monitor, and 8 had never self-monitored). Thematic analysis was undertaken.RESULTS: Three main themes emerged: 'self' and 'living with hypertension' described the emotional element of living with an asymptomatic condition; 'self-monitoring behaviour and medication' described overall views about self-monitoring, current practice, reasons for monitoring, and the impact on medication adherence; and 'the GP-patient transaction' described the power relations affecting decisions to self-monitor. Self-monitoring was performed by some as a protective tool against the fears of a silent but serious condition, whereas others self-monitor simply out of curiosity. People who self-monitored tended not to discuss this with their nurse or GP, partly due to perceiving minimal or no interest from their clinician about home monitoring, and partly due to fear of being prescribed additional medication.CONCLUSION: The decision to self-monitor appeared often to be an individual choice with no schedule or systems to integrate it with other medical care. Better recognition by clinicians that patients are self-monitoring, perhaps utilising the results in shared decision-making, might help integrate it into daily practice.

KW - Primary care

KW - Self-monitoring

KW - Hypertension

KW - Motivation

KW - Qualitative

U2 - 10.3399/bjgp15X687433

DO - 10.3399/bjgp15X687433

M3 - Article

C2 - 26500326

VL - 65

SP - e776-83

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 640

ER -