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Research Article: Exploring the patient experience of remote hypertension management in Scotland during COVID-19: a qualitative study

Date Published: 2023-12-09

Abstract:
Objectives The aim of this study was to understand how patients experienced hypertension management, with or without blood pressure (BP) telemonitoring, during the COVID-19 pandemic. Design, methods, participants and setting This qualitative study conducted between April and November 2022 consisted of 43 semistructured telephone interviews (23 men and 20?women) from 6 primary care practices in one area of Scotland. Results From the views of 25 participants with experience of using the Connect Me telemonitoring service and 18 participants without such experience, 5 themes were developed. These were: (1) navigating access to services. There were challenges to gaining timely and/or in-person access to services and a reluctance to attend clinical settings because participants were aware of their increased risk of contracting the COVID-19 virus. (2) Adapting National Health Service services. All six practices had adapted care provision in response to potential COVID-19 transmission; however, these adaptations disrupted routine management of in-person primary care hypertension, diabetes and/or asthma checks. (3) Telemonitoring feedback. Telemonitoring reduced the need to attend in-person primary care practices and supported access to remote healthcare monitoring and feedback. (4) Self-management. Many non-telemonitoring participants were motivated to use self-management strategies to track their BP using home monitoring equipment. Also, participants were empowered to self-manage lifestyle and hypertension medication. (5) Experience of having COVID-19. Some participants contracting the COVID-19 virus experienced an immediate increase in their BP while a few experienced ongoing increased BP readings. Conclusions The COVID-19 pandemic disrupted routine in-person care for patients with hypertension. Both telemonitoring and some non-telemonitoring patients were motivated to self-manage hypertension, including self-adjusting medication; however, only those with access to telemonitoring had increased access to hypertension monitoring and feedback. BP telemonitoring permitted routine care to continue for participants in this study and may offer a service useful in pandemic proofing hypertension healthcare in the future.

Introduction:
Hypertension is a leading preventable risk factor for cardiovascular disease (CVD) which affects approximately 1.28?billion people worldwide. 1 In Scotland, 30% of adults are known to have high blood pressure (BP), 2 with prevalence increasing with age. Uncontrolled hypertension is associated with worse cardiovascular outcomes. 3 Hypertension is associated with an increased risk of COVID-19 related mortality, 4 5 and those with untreated hypertension have significantly higher risk of COVID-19 mortality compared…

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