Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients.
<p><strong>BACKGROUND:</strong> Out-of-office blood pressure (BP) is recommended for diagnosing hypertension in primary care due to its increased accuracy compared to office BP. Moreover, being diagnosed as hypertensive has previously been linked to lower wellbeing. There is limite...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2019
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| _version_ | 1797086658897641472 |
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| author | Tompson, A Ward, A McManus, R Perera, R Thompson, M Heneghan, C Nunan, D |
| author_facet | Tompson, A Ward, A McManus, R Perera, R Thompson, M Heneghan, C Nunan, D |
| author_sort | Tompson, A |
| collection | OXFORD |
| description | <p><strong>BACKGROUND:</strong> Out-of-office blood pressure (BP) is recommended for diagnosing hypertension in primary care due to its increased accuracy compared to office BP. Moreover, being diagnosed as hypertensive has previously been linked to lower wellbeing. There is limited evidence regarding the acceptability of out-of-office BP and its impact on wellbeing.</p> <p><strong>AIM:</strong> To assess the acceptability and psychological impact of out-of-office monitoring in people with suspected hypertension.</p> <p><strong>DESIGN AND SETTING:</strong> A pre- and post-evaluation of participants with elevated (≥130 mmHg) systolic BP, assessing the psychological impact of 28 days of self-monitoring followed by ambulatory BP monitoring for 24 hours.</p> <p><strong>METHOD:</strong> Participants completed standardised psychological measures pre- and post-monitoring, and a validated acceptability scale post-monitoring. Descriptive data were compared using χ2 tests and binary logistic regression. Pre- and post-monitoring comparisons were made using the paired t-test and Wilcoxon signed rank test.</p> <p><strong>RESULTS:</strong> Out-of-office BP monitoring had no impact on depression and anxiety status in 93% and 85% of participants, respectively. Self-monitoring was more acceptable than ambulatory monitoring (n = 183, median 2.4, interquartile range [IQR] 1.9-3.1 versus median 3.2, IQR 2.7-3.7, P<0.01). When asked directly, 48/183 participants (26%, 95% confidence interval [CI] = 20 to 33%) reported that self-monitoring made them anxious, and 55/183 (30%, 95% CI = 24 to 37%) reported that ambulatory monitoring made them anxious.</p> <p><strong>CONCLUSION:</strong> Out-of-office monitoring for hypertension diagnosis does not appear to be harmful. However, health professionals should be aware that in some patients it induces feelings of anxiety, and self-monitoring may be preferable to ambulatory monitoring.</p> |
| first_indexed | 2024-03-07T02:25:04Z |
| format | Journal article |
| id | oxford-uuid:a5504282-739f-4cd1-9f65-13289a612060 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:25:04Z |
| publishDate | 2019 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:a5504282-739f-4cd1-9f65-13289a6120602022-03-27T02:39:39ZAcceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a5504282-739f-4cd1-9f65-13289a612060EnglishSymplectic Elements at OxfordRoyal College of General Practitioners2019Tompson, AWard, AMcManus, RPerera, RThompson, MHeneghan, CNunan, D<p><strong>BACKGROUND:</strong> Out-of-office blood pressure (BP) is recommended for diagnosing hypertension in primary care due to its increased accuracy compared to office BP. Moreover, being diagnosed as hypertensive has previously been linked to lower wellbeing. There is limited evidence regarding the acceptability of out-of-office BP and its impact on wellbeing.</p> <p><strong>AIM:</strong> To assess the acceptability and psychological impact of out-of-office monitoring in people with suspected hypertension.</p> <p><strong>DESIGN AND SETTING:</strong> A pre- and post-evaluation of participants with elevated (≥130 mmHg) systolic BP, assessing the psychological impact of 28 days of self-monitoring followed by ambulatory BP monitoring for 24 hours.</p> <p><strong>METHOD:</strong> Participants completed standardised psychological measures pre- and post-monitoring, and a validated acceptability scale post-monitoring. Descriptive data were compared using χ2 tests and binary logistic regression. Pre- and post-monitoring comparisons were made using the paired t-test and Wilcoxon signed rank test.</p> <p><strong>RESULTS:</strong> Out-of-office BP monitoring had no impact on depression and anxiety status in 93% and 85% of participants, respectively. Self-monitoring was more acceptable than ambulatory monitoring (n = 183, median 2.4, interquartile range [IQR] 1.9-3.1 versus median 3.2, IQR 2.7-3.7, P<0.01). When asked directly, 48/183 participants (26%, 95% confidence interval [CI] = 20 to 33%) reported that self-monitoring made them anxious, and 55/183 (30%, 95% CI = 24 to 37%) reported that ambulatory monitoring made them anxious.</p> <p><strong>CONCLUSION:</strong> Out-of-office monitoring for hypertension diagnosis does not appear to be harmful. However, health professionals should be aware that in some patients it induces feelings of anxiety, and self-monitoring may be preferable to ambulatory monitoring.</p> |
| spellingShingle | Tompson, A Ward, A McManus, R Perera, R Thompson, M Heneghan, C Nunan, D Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients. |
| title | Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients. |
| title_full | Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients. |
| title_fullStr | Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients. |
| title_full_unstemmed | Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients. |
| title_short | Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients. |
| title_sort | acceptability and psychological impact of out of office monitoring to diagnose hypertension an evaluation of survey data from primary care patients |
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