Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses
<p><strong>Background:</strong> The COVID-19 pandemic has accelerated adoption of remote consulting in healthcare. Despite opportunities posed by telemedicine, most hypertension services in Europe have suspended ambulatory blood pressure monitoring (ABPM).</p> <p><st...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
F1000Research
2022
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| _version_ | 1826309676309938176 |
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| author | Armitage, LC Lawson, BK Roman, C Thompson, B Biggs, C Rutter, H Lewis-Jones, M Ede, J Tarassenko, L Farmer, A Watkinson, P |
| author_facet | Armitage, LC Lawson, BK Roman, C Thompson, B Biggs, C Rutter, H Lewis-Jones, M Ede, J Tarassenko, L Farmer, A Watkinson, P |
| author_sort | Armitage, LC |
| collection | OXFORD |
| description | <p><strong>Background:</strong> The COVID-19 pandemic has accelerated adoption of remote consulting in healthcare. Despite opportunities posed by telemedicine, most hypertension services in Europe have suspended ambulatory blood pressure monitoring (ABPM).</p>
<p><strong>Methods:</strong> We examined the process and performance of remotely delivered ABPM using two methodologies: firstly, a Failure Modes and Effects Analysis (FMEA) and secondly, a quantitative analysis comparing ABPM data from a subgroup of 65 participants of the Screening for Hypertension in the INpatient Environment (SHINE) diagnostic accuracy study. The FMEA was performed over seven sessions from February to March 2021, with a multidisciplinary team comprising a patient representative, a research coordinator with technical expertise and four research clinicians.</p>
<p><strong>Results:</strong> The FMEA identified a single high-risk step in the remote ABPM process. This was cleaning of monitoring equipment in the context of the COVID-19 pandemic, unrelated to the remote setting.
A total of 14 participants were scheduled for face-to-face ABPM appointments, before the UK March 2020 COVID-19 lockdown; 62 were scheduled for remote ABPM appointments since emergence of the COVID-19 pandemic between November 2020 and August 2021. A total of 65 (88%) participants completed ABPMs; all obtained sufficient successful measurements for interpretation. For the 10 participants who completed face-to-face ABPM, there were 402 attempted ABPM measurements and 361 (89%) were successful. For the 55 participants who completed remote ABPM, there were 2516 attempted measurements and 2214 (88%) were successful. There was no significant difference in the mean per-participant error rate between face-to-face (0.100, SD 0.009) and remote (0.143, SD 0.132) cohorts (95% CI for the difference -0.125 to 0.045 and two-tailed P-value 0.353).</p>
<p><strong>Conclusions:</strong> We have demonstrated that ABPM can be safely and appropriately provided in the community remotely and without face-to-face contact, using video technology for remote fitting appointments, alongside courier services for delivery of equipment to participants.</p> |
| first_indexed | 2024-03-07T07:37:54Z |
| format | Journal article |
| id | oxford-uuid:5ffcf59d-4f8d-41ec-bac8-b257ccdf2930 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:37:54Z |
| publishDate | 2022 |
| publisher | F1000Research |
| record_format | dspace |
| spelling | oxford-uuid:5ffcf59d-4f8d-41ec-bac8-b257ccdf29302023-03-31T16:49:15ZAmbulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analysesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5ffcf59d-4f8d-41ec-bac8-b257ccdf2930EnglishSymplectic ElementsF1000Research2022Armitage, LCLawson, BKRoman, CThompson, BBiggs, CRutter, HLewis-Jones, MEde, JTarassenko, LFarmer, AWatkinson, P<p><strong>Background:</strong> The COVID-19 pandemic has accelerated adoption of remote consulting in healthcare. Despite opportunities posed by telemedicine, most hypertension services in Europe have suspended ambulatory blood pressure monitoring (ABPM).</p> <p><strong>Methods:</strong> We examined the process and performance of remotely delivered ABPM using two methodologies: firstly, a Failure Modes and Effects Analysis (FMEA) and secondly, a quantitative analysis comparing ABPM data from a subgroup of 65 participants of the Screening for Hypertension in the INpatient Environment (SHINE) diagnostic accuracy study. The FMEA was performed over seven sessions from February to March 2021, with a multidisciplinary team comprising a patient representative, a research coordinator with technical expertise and four research clinicians.</p> <p><strong>Results:</strong> The FMEA identified a single high-risk step in the remote ABPM process. This was cleaning of monitoring equipment in the context of the COVID-19 pandemic, unrelated to the remote setting. A total of 14 participants were scheduled for face-to-face ABPM appointments, before the UK March 2020 COVID-19 lockdown; 62 were scheduled for remote ABPM appointments since emergence of the COVID-19 pandemic between November 2020 and August 2021. A total of 65 (88%) participants completed ABPMs; all obtained sufficient successful measurements for interpretation. For the 10 participants who completed face-to-face ABPM, there were 402 attempted ABPM measurements and 361 (89%) were successful. For the 55 participants who completed remote ABPM, there were 2516 attempted measurements and 2214 (88%) were successful. There was no significant difference in the mean per-participant error rate between face-to-face (0.100, SD 0.009) and remote (0.143, SD 0.132) cohorts (95% CI for the difference -0.125 to 0.045 and two-tailed P-value 0.353).</p> <p><strong>Conclusions:</strong> We have demonstrated that ABPM can be safely and appropriately provided in the community remotely and without face-to-face contact, using video technology for remote fitting appointments, alongside courier services for delivery of equipment to participants.</p> |
| spellingShingle | Armitage, LC Lawson, BK Roman, C Thompson, B Biggs, C Rutter, H Lewis-Jones, M Ede, J Tarassenko, L Farmer, A Watkinson, P Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses |
| title | Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses |
| title_full | Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses |
| title_fullStr | Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses |
| title_full_unstemmed | Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses |
| title_short | Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses |
| title_sort | ambulatory blood pressure monitoring using telemedicine proof of concept cohort and failure modes and effects analyses |
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