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Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study

Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study
Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study
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
0960-1643
e135-e142
Jones, Miren I.
b1e4c78a-c29e-49e8-8a6e-5fea581da3ea
Greenfield, Shiela M.
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Bray, Emma P.
a4338352-cb2e-4589-a0f7-33c1e80b7b39
Baral-Grant, Sabrina
d01f1d64-654c-4feb-88f2-69532669683e
Hobbs, F.D.
33a12491-7fa9-4459-b875-bb1f2b23e2c0
Holder, Roger
5a56c2c5-8965-4f4f-b0ba-8789f24bab85
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Mant, Jonanthan
d48436e7-4ff8-4a21-9270-9adbd5bbe87c
Virdee, Satnam K.
0fcd01e5-c7c0-467f-b4de-427faf6ced7a
Williams, Bryan
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McManus, Richard J.
481f6284-d599-4c77-8869-d1c6b63b9b02
Jones, Miren I.
b1e4c78a-c29e-49e8-8a6e-5fea581da3ea
Greenfield, Shiela M.
0010c4df-72ef-435b-aa4e-7404a7bf9c0f
Bray, Emma P.
a4338352-cb2e-4589-a0f7-33c1e80b7b39
Baral-Grant, Sabrina
d01f1d64-654c-4feb-88f2-69532669683e
Hobbs, F.D.
33a12491-7fa9-4459-b875-bb1f2b23e2c0
Holder, Roger
5a56c2c5-8965-4f4f-b0ba-8789f24bab85
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Mant, Jonanthan
d48436e7-4ff8-4a21-9270-9adbd5bbe87c
Virdee, Satnam K.
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Williams, Bryan
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McManus, Richard J.
481f6284-d599-4c77-8869-d1c6b63b9b02

Jones, Miren I., Greenfield, Shiela M., Bray, Emma P., Baral-Grant, Sabrina, Hobbs, F.D., Holder, Roger, Little, Paul, Mant, Jonanthan, Virdee, Satnam K., Williams, Bryan and McManus, Richard J. (2012) Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study. British Journal of General Practice, 62 (595), e135-e142. (doi:10.3399/bjgp12X625201). (PMID:22520791)

Record type: Article

Abstract

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

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More information

Published date: February 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 350002
URI: http://eprints.soton.ac.uk/id/eprint/350002
ISSN: 0960-1643
PURE UUID: 26d8e8f3-3b4f-47fe-9a73-26df646516ba

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Date deposited: 15 Mar 2013 14:35
Last modified: 08 Nov 2021 23:42

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Contributors

Author: Miren I. Jones
Author: Shiela M. Greenfield
Author: Emma P. Bray
Author: Sabrina Baral-Grant
Author: F.D. Hobbs
Author: Roger Holder
Author: Paul Little
Author: Jonanthan Mant
Author: Satnam K. Virdee
Author: Bryan Williams
Author: Richard J. McManus

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