Mixed-methods feasibility study of blood pressure self-screening for hypertension detection

Research output: Contribution to journalArticlepeer-review

Authors

  • Alice C. Tompson
  • Susannah Fleming
  • Mei-Man Lee
  • David McCartney
  • Carl J. Heneghan
  • Alison M Ward
  • Richard Hobbs
  • Richard J McManus

Colleges, School and Institutes

External organisations

  • Nuffield Department of Primary Care Health Sciences
  • Nuffield Department of Primary Care Health Sciences, University of Oxford
  • NIHR School for Primary Care Research
  • University of Oxford

Abstract

Objective To assess the feasibility of using a blood pressure (BP) self-measurement kiosk-a solid-cuff sphygmomanometer combined with technology to integrate the BP readings into patient electronic medical records-To improve hypertension detection. Design A concurrent mixed-methods feasibility study incorporating observational and qualitative interview components. Setting Two English general practitioner (GP) surgeries. Participants Adult patients registered at participating surgeries. Staff working at these sites. Interventions BP self-measurement kiosks were placed in the waiting rooms for a 12-month period between 2015 and 2016 and compared with a 12-month control period prior to installation. Outcome measures (1) The number of patients using the kiosk and agreeing to transfer of their data into their electronic medical records; (2) the cost of using a kiosk compared with GP/practice nurse BP screening; (3) qualitative themes regarding use of the equipment. Results Out of 15 624 eligible patients, only 186 (1.2%, 95% CI 1.0% to 1.4%) successfully used the kiosk to directly transfer a BP reading into their medical record. For a considerable portion of the intervention period, no readings were transferred, possibly indicating technical problems with the transfer link. A comparison of costs suggests that at least 52.6% of eligible patients would need to self-screen in order to bring costs below that of screening by GPs and practice nurses. Qualitative interviews confirmed that both patients and staff experienced technical difficulties, and used alternative methods to enter BP results into the medical record. Conclusions While interviewees were generally positive about checking BP in the waiting room, the electronic transfer system as tested was neither robust, effective nor likely to be a cost-effective approach, thus may not be appropriate for a primary care environment. Since most of the cost of a kiosk system lies in the transfer mechanism, a solid-cuff sphygmomanometer and manual entry of results may be a suitable alternative.

Bibliographic note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

Details

Original languageEnglish
Article numbere027986
Number of pages9
JournalBMJ open
Volume9
Issue number5
Publication statusPublished - 29 May 2019

Keywords

  • Hypertension, blood pressure, diagnostic self-evaluation, screening kiosks, primary health care