Home blood pressure monitoring - What is the most feasible and acceptable schedule? A qualitative study

Background: Self-monitoring of blood pressure (SMBP) has the potential to better estimate underlying blood pressure (BP), is increasingly popular with patients, and is endorsed in hypertension guidelines worldwide. Despite the growing popularity of home blood pressure monitoring there is currently no evidence based schedule that is recommended for patient use and little is known about the feasibility and acceptability of available self-monitoring schedules. This qualitative study explored the views and experiences of patients and health care professionals (HCPs) on acceptable and feasible self-monitoring schedules, informed by a recent systematic review and national clinical guidelines. Methods: 14 focus groups: 10 primary care [4 with HCPs, 6 with patients, with and without experience of self-monitoring], and 4 secondary care [1 HCP, 3 patients] plus 3 interviews with secondary care HCPs. Interviews and focus groups, supported by field notes, were recorded, transcribed verbatim and analysed by constant comparative method. Results: Preliminary analysis suggests patients generally supported structured schedules, preferred a 3-day monitoring schedule (2x daily) over a longer 7-day period, but felt schedules must have a degree of flexibility to adapt to individual routines. HCPs made a clear distinction between 7-day schedules which were considered better for diagnosis and 3-day schedules which were considered adequate for follow up. HCPS thought that a formalised schedule could reduce panic about one-off high readings but expressed concern how compliance with schedules could be monitored. Conclusions: This qualitative study provided an insight into patients’ and HCPs’ views and experiences about schedules for self-monitoring.