title: Patients' and clinicians' views on the optimum schedules for self-monitoring of blood pressure: a qualitative focus group and interview study.
abstract: BACKGROUND
  Self-monitoring of blood pressure is common but guidance on how it should be carried out varies and it is currently unclear how such guidance is viewed.
  
  
  OBJECTIVE
  To explore patients' and healthcare professionals' (HCPs) views and experiences of the use of different self-monitoring regimens to determine what is acceptable and feasible, and to inform future recommendations.
  
  
  METHODS
  Thirteen focus groups and four HCP interviews were held, with a total of 66 participants (41 patients and 25 HCPs) from primary and secondary care with and without experience of self-monitoring.
  
  
  METHODS
  Standard and shortened self-monitoring protocols were both considered. Focus groups and interviews were recorded, transcribed verbatim, and analysed using the constant comparative method.
  
  
  RESULTS
  Patients generally supported structured schedules but with sufficient flexibility to allow adaptation to individual routine. They preferred a shorter (3-day) schedule to longer (7-day) regimens. Although HCPs could describe benefits for patients of using a schedule, they were reluctant to recommend a specific schedule. Concerns surrounded the use of different schedules for diagnosis and subsequent monitoring. Appropriate education was seen as vital by all participants to enable a self-monitoring schedule to be followed at home.
  
  
  CONCLUSIONS
  There is not a 'one size fits all approach' to developing the optimum protocol from the perspective of users and those implementing it. An approach whereby patients are asked to complete the minimum number of readings required for accurate blood pressure estimation in a flexible manner seems most likely to succeed. Informative advice and guidance should incorporate such flexibility for patients and professionals alike.
authors.affiliation: Primary Care Clinical Sciences, Institute of Applied Health Research, College of Medical and Dental Sciences.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Grant
authors.affiliation: Primary Care Clinical Sciences, Institute of Applied Health Research, College of Medical and Dental Sciences.
authors.forename: James A
authors.initials: JA
authors.lastname: Hodgkinson
authors.affiliation: Primary Care Clinical Sciences, Institute of Applied Health Research, College of Medical and Dental Sciences.
authors.forename: Siobhan L
authors.initials: SL
authors.lastname: Milner
authors.affiliation: Clinical Research Support Facility, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham.
authors.forename: Una
authors.initials: U
authors.lastname: Martin
authors.affiliation: Primary Care Health Sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
authors.forename: Alice
authors.initials: A
authors.lastname: Tompson
authors.affiliation: Primary Care Health Sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
authors.forename: Fd Richard
authors.initials: FR
authors.lastname: Hobbs
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mant
authors.affiliation: Primary Care Health Sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: McManus
authors.affiliation: Primary Care Clinical Sciences, Institute of Applied Health Research, College of Medical and Dental Sciences.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Greenfield
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D018660:Blood Pressure Monitoring, Ambulatory; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D063127:Secondary Health Care / Q000458:organization & administration*; D012648:Self Care
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; focus groups; hypertension; primary health care; secondary care; self-monitoring