title: Experiences of patients and professionals participating in the HITS home blood pressure telemonitoring trial: a qualitative study.
abstract: OBJECTIVE
  To explore the experiences of patients and professionals taking part in a randomised controlled trial (RCT) of remote blood pressure (BP) telemonitoring supported by primary care. To identify factors facilitating or hindering the effectiveness of the intervention and those likely to influence its potential translation to routine practice.
  
  
  METHODS
  Qualitative study adopting a qualitative descriptive approach.
  
  
  METHODS
  25 patients, 11 nurses and 9 doctors who were participating in an RCT of BP telemonitoring. A maximum variation sample of patients from within the trial based on age, sex and deprivation status of the practice was sought.
  
  
  METHODS
  6 primary care practices in Scotland.
  
  
  METHODS
  Data were collected via taped semistructured interviews. Initial thematic analysis was inductive. Multiple strategies were employed to ensure that the analysis was credible and trustworthy.
  
  
  RESULTS
  Prior to the trial, both patients and professionals were reluctant to increase the medication based on single BP measurements taken in the surgery. BP measurements based on multiple electronic readings were perceived as more accurate as a basis for action. Patients using telemonitoring became more engaged in the clinical management of their condition. Professionals reported that telemonitoring challenged existing roles and work practices and increased workload. Lack of integration of telemonitoring data with the electronic health record was perceived as a drawback.
  
  
  CONCLUSIONS
  BP telemonitoring in a usual care setting can provide a trusted basis for medication management and improved BP control. It increases patients' engagement in the management of their condition, but supporting telemetry and greater patient engagement can increase professional workloads and demand changes in service organisation. Successful service design in practice would have to take account of how additional roles and responsibilities could be realigned with existing work and data management practices. The embedded qualitative study was included in the protocol for the HITS trial registered with ISRCTN no. 72614272.
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Hanley
authors.forename: Jenny
authors.initials: J
authors.lastname: Ure
authors.forename: Claudia
authors.initials: C
authors.lastname: Pagliari
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
authors.forename: Brian
authors.initials: B
authors.lastname: McKinstry
keywords: Primary Care; Qualitative Research