Developing an interactive mobile phone self-report system for self-management of hypertension. Part 1: Patient and professional perspectives

Abstract

Low adherence remains a struggle in hypertension management, despite improvement efforts. Presuming that increased patient participation is a possible approach, we collaborated with patients and healthcare professionals to design a self-report system to support self-management. The study aimed to explore and describe relevant aspects of hypertension and hypertension treatment, for use in the development of an interactive mobile phone self-report system. It further aimed to suggest which clinical measures, lifestyle measures, symptoms and side-effects of treatment would be meaningful to include in such a system. Five focus group interviews were performed with 15 patients and 12 healthcare professionals, and data was analysed using thematic analysis. Patients suggested trust, a good relationship with caregivers, and well-being as important aspects of hypertension self-management. Furthermore, they regarded blood pressure, dizziness, stress, headache and tiredness as important outcomes to include. Patients sought to understand interconnections between symptoms and variations in blood pressure, whilst healthcare professionals doubted patients’ ability to do so. Healthcare professionals emphasized accessibility, clear and consistent counselling, complication prevention and educational efforts. The study presents aspects of importance for follow-up to understand the interplay between blood pressure and daily life experiences for patients with hypertension.

The development of consumer mHealth interventions for chronic condition self-management: A systematic review.

“…Patient enablement of self-management was the most commonly reported impetus for mHealth development. The objective is to provide self-management support [10,11,[15][16][17][18]25], related to treatment adherence [11,13], skill development [22] and knowledge translation [20,23]. Behaviour change modification was highlighted as a significant precluding development factor [25], with physical activity or diet [10] and daily management challenges [17] a specific target.…”

“…The greatest number of patient participants reported in this review was for the development of mHypertension a , consisting of 15, 21 and 50 patients depending on the development phase [13]. Most commonly, five to 15 patient participants with a diagnosis of the targeted condition were involved in the development [9,11,19,26]. Eight 'users' of different backgrounds were engaged developing the m.CARAT application [15] and 25 users for AMICA intervention representative of the target population in this case, senior users with limited computer skills [23].…”

“…Described thoroughly in the articles relating to the development of mHyptertension a [11], and as an example of the potential for tension which may affect mHealth design, patient and healthcare professional perspectives differed significantly. This study uncovered that overall, patients wanted more control in disease self-management.…”

“…This study uncovered that overall, patients wanted more control in disease self-management. From the patient's perspective, becoming a 'participating and knowledgeable patient' was an important factor in hypertension management [11]. Patients prioritised the need to see relationship between symptoms, side-effects and understand the effect treatment had on their general health and family life [11].…”

“…Healthcare professionals however, were found to doubt patient self-management abilities. Healthcare professionals were uncertain their patients would become a 'participating and knowledgeable patient' and nurses specifically were hesitant that patients had the ability to understand and interpret blood pressure readings [11].…”