RT Journal Article
SR Electronic
T1 Patients’ experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e135
OP e142
DO 10.3399/bjgp12X625201
VO 62
IS 595
A1 Miren I Jones
A1 Sheila M Greenfield
A1 Emma P Bray
A1 Sabrina Baral-Grant
A1 FD Richard Hobbs
A1 Roger Holder
A1 Paul Little
A1 Jonathan Mant
A1 Satnam K Virdee
A1 Bryan Williams
A1 Richard J McManus
YR 2012
UL http://bjgp.org/content/62/595/e135.abstract
AB 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.