Patient and Health Professional Perceptions of Telemonitoring for Hypertension Management: Qualitative Study

Background: Hypertension is the most prevalent and important risk factor for cardiovascular disease, affecting nearly 50% of the US adult population; however, only 30% of these patients achieve controlled blood pressure (BP). Incorporating strategies into primary care that take into consideration in...

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Main Authors: Baratta, J. (Author), Brown-Johnson, C. (Author), Mahoney, M. (Author), Palaniappan, L. (Author), Rosas, L.G (Author), Safaeinili, N. (Author), Winget, M. (Author)
Format: Article
Language:English
Published: JMIR Publications Inc. 2022
Subjects:
Online Access:View Fulltext in Publisher
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020 |a 2561326X (ISSN) 
245 1 0 |a Patient and Health Professional Perceptions of Telemonitoring for Hypertension Management: Qualitative Study 
260 0 |b JMIR Publications Inc.  |c 2022 
520 3 |a Background: Hypertension is the most prevalent and important risk factor for cardiovascular disease, affecting nearly 50% of the US adult population; however, only 30% of these patients achieve controlled blood pressure (BP). Incorporating strategies into primary care that take into consideration individual patient needs, such as remote BP monitoring, may improve hypertension management. Objective: From March 2018 to December 2018, Stanford implemented a precision health pilot called Humanwide, which aimed to leverage high-technology and high-touch medicine to tailor individualized care for conditions such as hypertension. We examined multi-stakeholder perceptions of hypertension management in Humanwide to evaluate the program’s acceptability, appropriateness, feasibility, and sustainability. Methods: We conducted semistructured interviews with 16 patients and 15 health professionals to assess their experiences with hypertension management in Humanwide. We transcribed and analyzed the interviews using a hybrid approach of inductive and deductive analysis to identify common themes around hypertension management and consensus methods to ensure reliability and validity. Results: A total of 63% (10/16) of the patients and 40% (6/15) of the health professionals mentioned hypertension in the context of Humanwide. These participants reported that remote BP monitoring improved motivation, BP control, and overall clinic efficiency. The health professionals discussed feasibility challenges, including the time needed to analyze BP data and provide individualized feedback, integration of BP data, technological difficulties with the BP cuff, and decreased patient use of remote BP monitoring over time. Conclusions: Remote BP monitoring for hypertension management in Humanwide was acceptable to patients and health professionals and appropriate for care. Important challenges need to be addressed to improve the feasibility and sustainability of this approach by leveraging team-based care, engaging patients to sustain remote BP monitoring, standardizing electronic medical record integration of BP measurements, and finding more user-friendly BP cuffs. © Juliana Baratta, Cati Brown-Johnson, Nadia Safaeinili, Lisa Goldman Rosas, Latha Palaniappan, Marcy Winget, Megan Mahoney. Originally published in JMIR Formative Research (https://formative.jmir.org), 10.06.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included. 
650 0 4 |a hypertension 
650 0 4 |a mobile phone 
650 0 4 |a precision health 
650 0 4 |a remote blood pressure monitoring 
700 1 0 |a Baratta, J.  |e author 
700 1 0 |a Brown-Johnson, C.  |e author 
700 1 0 |a Mahoney, M.  |e author 
700 1 0 |a Palaniappan, L.  |e author 
700 1 0 |a Rosas, L.G.  |e author 
700 1 0 |a Safaeinili, N.  |e author 
700 1 0 |a Winget, M.  |e author 
773 |t JMIR Formative Research 
856 |z View Fulltext in Publisher  |u https://doi.org/10.2196/32874