Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.

BACKGROUND: Self-management of hypertension, comprising self-monitoring of blood pressure with self-titration of medication, improves blood pressure control, but little is known regarding the views of patients undertaking it. AIM: To explore patients' views of self-monitoring blood pressure an...

Full description

Bibliographic Details
Main Authors: Jones, M, Greenfield, S, Bray, E, Baral-Grant, S, Hobbs, F, Holder, R, Little, P, Mant, J, Virdee, S, Williams, B, McManus, R
Format: Journal article
Language:English
Published: 2012
_version_ 1797069995790827520
author Jones, M
Greenfield, S
Bray, E
Baral-Grant, S
Hobbs, F
Holder, R
Little, P
Mant, J
Virdee, S
Williams, B
McManus, R
author_facet Jones, M
Greenfield, S
Bray, E
Baral-Grant, S
Hobbs, F
Holder, R
Little, P
Mant, J
Virdee, S
Williams, B
McManus, R
author_sort Jones, M
collection OXFORD
description BACKGROUND: Self-management of hypertension, comprising self-monitoring of blood pressure with self-titration of medication, improves blood pressure control, but little is known regarding the views of patients undertaking it. AIM: To explore patients' views of self-monitoring blood pressure and self-titration of antihypertensive medication. DESIGN AND SETTING: Qualitative study embedded within the randomised controlled trial TASMINH2 (Telemonitoirng and Self Management in the Control of Hypertension) trial of patient self-management of hypertension from 24 general practices in the West Midlands. METHOD: Taped and transcribed semi-structured interviews with 23 intervention patients were used. Six family members were also interviewed. Analysis was by a constant comparative method. RESULTS: Patients were confident about self-monitoring and many felt their multiple home readings were more valid than single office readings taken by their GP. Although many patients self-titrated medication when required, others lacked the confidence to increase medication without reconsulting with their GP. Patients were more comfortable with titrating medication if their blood pressure readings were substantially above target, but were reluctant to implement such a change if readings were borderline. Many planned to continue self-monitoring after the study finished and report home readings to their GP, but few wished to continue with a self-management plan. CONCLUSION: Participants valued the additional information and many felt confident in both self-monitoring blood pressure and self-titrating medication. The reluctance to change medication for borderline readings suggests behaviour similar to the clinical inertia seen for physicians in analogous circumstances. Additional support for those lacking in confidence to implement prearranged medication changes may allow more patients to undertake self-management.
first_indexed 2024-03-06T22:32:39Z
format Journal article
id oxford-uuid:58c93609-dfc7-4d72-91e2-f86d13383d2e
institution University of Oxford
language English
last_indexed 2024-03-06T22:32:39Z
publishDate 2012
record_format dspace
spelling oxford-uuid:58c93609-dfc7-4d72-91e2-f86d13383d2e2022-03-26T17:05:47ZPatients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:58c93609-dfc7-4d72-91e2-f86d13383d2eEnglishSymplectic Elements at Oxford2012Jones, MGreenfield, SBray, EBaral-Grant, SHobbs, FHolder, RLittle, PMant, JVirdee, SWilliams, BMcManus, RBACKGROUND: Self-management of hypertension, comprising self-monitoring of blood pressure with self-titration of medication, improves blood pressure control, but little is known regarding the views of patients undertaking it. AIM: To explore patients' views of self-monitoring blood pressure and self-titration of antihypertensive medication. DESIGN AND SETTING: Qualitative study embedded within the randomised controlled trial TASMINH2 (Telemonitoirng and Self Management in the Control of Hypertension) trial of patient self-management of hypertension from 24 general practices in the West Midlands. METHOD: Taped and transcribed semi-structured interviews with 23 intervention patients were used. Six family members were also interviewed. Analysis was by a constant comparative method. RESULTS: Patients were confident about self-monitoring and many felt their multiple home readings were more valid than single office readings taken by their GP. Although many patients self-titrated medication when required, others lacked the confidence to increase medication without reconsulting with their GP. Patients were more comfortable with titrating medication if their blood pressure readings were substantially above target, but were reluctant to implement such a change if readings were borderline. Many planned to continue self-monitoring after the study finished and report home readings to their GP, but few wished to continue with a self-management plan. CONCLUSION: Participants valued the additional information and many felt confident in both self-monitoring blood pressure and self-titrating medication. The reluctance to change medication for borderline readings suggests behaviour similar to the clinical inertia seen for physicians in analogous circumstances. Additional support for those lacking in confidence to implement prearranged medication changes may allow more patients to undertake self-management.
spellingShingle Jones, M
Greenfield, S
Bray, E
Baral-Grant, S
Hobbs, F
Holder, R
Little, P
Mant, J
Virdee, S
Williams, B
McManus, R
Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
title Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
title_full Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
title_fullStr Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
title_full_unstemmed Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
title_short Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
title_sort patients experiences of self monitoring blood pressure and self titration of medication the tasminh2 trial qualitative study
work_keys_str_mv AT jonesm patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT greenfields patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT braye patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT baralgrants patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT hobbsf patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT holderr patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT littlep patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT mantj patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT virdees patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT williamsb patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy
AT mcmanusr patientsexperiencesofselfmonitoringbloodpressureandselftitrationofmedicationthetasminh2trialqualitativestudy