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Understanding how primary care practitioners perceive an online intervention for the management of hypertension

Understanding how primary care practitioners perceive an online intervention for the management of hypertension
Understanding how primary care practitioners perceive an online intervention for the management of hypertension
Background: In order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP).

Methods: Our Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures. We took an iterative approach moving between data collection, analysis and modifications to the HOME BP intervention, followed by further data collection. The data was analysed using thematic analysis.

Results: Many aspects of HOME BP appeared to be acceptable, persuasive and feasible to implement. Practitioners perceived benefits in using HOME BP, including that it could empower patients to self-manage their health, potentially overcome clinical inertia around prescribing medication and save both the patient and practitioner time. However, practitioners also had some concerns. Some practitioners were concerned about the accuracy of patients’ home blood pressure readings, or the potential for home monitoring to cause patients anxiety and therefore increase consultations. Some GPs lacked confidence in choosing multiple medication changes, or had concerns about unanticipated drug interactions. A few nurses were concerned that the model of patient support they were asked to provide was not consistent with their perceived role. Modifications were made to the intervention based on this feedback, which appeared to help overcome practitioners’ concerns and improve the acceptability and feasibility of the intervention.

Conclusions: This paper provides a detailed example of using the Person-Based Approach to refine HOME BP, demonstrating how we improved the acceptability and feasibility of HOME BP based on feedback from practice staff. This demonstration may be useful to others developing digital interventions.
1-13
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
McManus, Richard
eac36c17-f265-499a-aaab-03f1a3df5286
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
McManus, Richard
eac36c17-f265-499a-aaab-03f1a3df5286
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Bradbury, Katherine, Morton, Kate, Band, Rebecca, May, Carl, McManus, Richard, Little, Paul and Yardley, Lucy (2017) Understanding how primary care practitioners perceive an online intervention for the management of hypertension. BMC Medical Informatics and Decision Making, 17 (5), 1-13. (doi:10.1186/s12911-016-0397-x).

Record type: Article

Abstract

Background: In order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP).

Methods: Our Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures. We took an iterative approach moving between data collection, analysis and modifications to the HOME BP intervention, followed by further data collection. The data was analysed using thematic analysis.

Results: Many aspects of HOME BP appeared to be acceptable, persuasive and feasible to implement. Practitioners perceived benefits in using HOME BP, including that it could empower patients to self-manage their health, potentially overcome clinical inertia around prescribing medication and save both the patient and practitioner time. However, practitioners also had some concerns. Some practitioners were concerned about the accuracy of patients’ home blood pressure readings, or the potential for home monitoring to cause patients anxiety and therefore increase consultations. Some GPs lacked confidence in choosing multiple medication changes, or had concerns about unanticipated drug interactions. A few nurses were concerned that the model of patient support they were asked to provide was not consistent with their perceived role. Modifications were made to the intervention based on this feedback, which appeared to help overcome practitioners’ concerns and improve the acceptability and feasibility of the intervention.

Conclusions: This paper provides a detailed example of using the Person-Based Approach to refine HOME BP, demonstrating how we improved the acceptability and feasibility of HOME BP based on feedback from practice staff. This demonstration may be useful to others developing digital interventions.

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More information

Accepted/In Press date: 9 December 2016
e-pub ahead of print date: 9 January 2017
Published date: 9 January 2017
Organisations: Faculty of Health Sciences, Primary Care & Population Sciences, Psychology

Identifiers

Local EPrints ID: 404950
URI: http://eprints.soton.ac.uk/id/eprint/404950
PURE UUID: efd634d5-53f1-4e34-a280-27e8aa69a1a1
ORCID for Katherine Bradbury: ORCID iD orcid.org/0000-0001-5513-7571
ORCID for Kate Morton: ORCID iD orcid.org/0000-0002-6674-0314
ORCID for Rebecca Band: ORCID iD orcid.org/0000-0001-5403-1708
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 25 Jan 2017 11:34
Last modified: 21 Sep 2024 01:49

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Contributors

Author: Kate Morton ORCID iD
Author: Rebecca Band ORCID iD
Author: Carl May ORCID iD
Author: Richard McManus
Author: Paul Little ORCID iD
Author: Lucy Yardley ORCID iD

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