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A qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK

A qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK
A qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK
Objectives: Digital interventions can change patients’ experiences of managing their health, either creating additional burden or improving their experience of healthcare. This qualitative study aimed to explore perceived burdens and benefits for patients using a digital self-management intervention for reducing high blood pressure. A secondary aim was to further our understanding of how best to capture burdens and benefits when evaluating health interventions.

Design: Inductive qualitative process study nested in a randomised controlled trial.

Setting: Primary Care in the UK.

Participants: 35 participants taking antihypertensive medication and with uncontrolled blood pressure at baseline participated in semi-structured telephone interviews.
Intervention: Digital self-management intervention to support blood pressure self-monitoring and medication change when recommended by the healthcare professional.
Analysis: Data were analysed using inductive thematic analysis with techniques from grounded theory.

Results: Seven themes were developed which reflected perceived burdens and benefits of using the intervention, including worry about health, uncertainty about self-monitoring, and reassurance. The analysis showed how beliefs about their condition and treatment appeared to influence participants’ appraisal of the value of the intervention. This suggested that considering illness and treatment perceptions in Burden of Treatment theory could further our understanding of how individuals appraise the personal costs and benefits of self-managing their health.

Conclusions: Patients’ appraisal of the burden or benefit of using a complex self-management intervention seemed to be influenced by experiences within the intervention (such as perceived availability of support) and beliefs about their condition and treatment (such as perceived control and risk of side effects). Developing our ability to adequately capture these salient burdens and benefits for patients could help enhance evaluation of self-management interventions in the future. Many participants perceived important benefits from using the intervention, highlighting the need for theory to recognise that engaging in self-management can include positive as well as negative aspects.
Self-management; digital intervention; qualitative; treatment burden
2044-6055
1-11
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
Dennison, Laura
15c399cb-9a81-4948-8906-21944c033c20
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
McManus, Richard
eac36c17-f265-499a-aaab-03f1a3df5286
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
Dennison, Laura
15c399cb-9a81-4948-8906-21944c033c20
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
McManus, Richard
eac36c17-f265-499a-aaab-03f1a3df5286
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Morton, Kate, Dennison, Laura, Bradbury, Katherine, Band, Rebecca, May, Carl, Raftery, James, Little, Paul, McManus, Richard and Yardley, Lucy (2018) A qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK. BMJ Open, 8, 1-11, [e020843]. (doi:10.1136/bmjopen-2017-020843).

Record type: Article

Abstract

Objectives: Digital interventions can change patients’ experiences of managing their health, either creating additional burden or improving their experience of healthcare. This qualitative study aimed to explore perceived burdens and benefits for patients using a digital self-management intervention for reducing high blood pressure. A secondary aim was to further our understanding of how best to capture burdens and benefits when evaluating health interventions.

Design: Inductive qualitative process study nested in a randomised controlled trial.

Setting: Primary Care in the UK.

Participants: 35 participants taking antihypertensive medication and with uncontrolled blood pressure at baseline participated in semi-structured telephone interviews.
Intervention: Digital self-management intervention to support blood pressure self-monitoring and medication change when recommended by the healthcare professional.
Analysis: Data were analysed using inductive thematic analysis with techniques from grounded theory.

Results: Seven themes were developed which reflected perceived burdens and benefits of using the intervention, including worry about health, uncertainty about self-monitoring, and reassurance. The analysis showed how beliefs about their condition and treatment appeared to influence participants’ appraisal of the value of the intervention. This suggested that considering illness and treatment perceptions in Burden of Treatment theory could further our understanding of how individuals appraise the personal costs and benefits of self-managing their health.

Conclusions: Patients’ appraisal of the burden or benefit of using a complex self-management intervention seemed to be influenced by experiences within the intervention (such as perceived availability of support) and beliefs about their condition and treatment (such as perceived control and risk of side effects). Developing our ability to adequately capture these salient burdens and benefits for patients could help enhance evaluation of self-management interventions in the future. Many participants perceived important benefits from using the intervention, highlighting the need for theory to recognise that engaging in self-management can include positive as well as negative aspects.

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A qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK. - Accepted Manuscript
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More information

Accepted/In Press date: 5 March 2018
e-pub ahead of print date: 8 May 2018
Additional Information: This independent research was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-1211-20001). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.
Keywords: Self-management; digital intervention; qualitative; treatment burden

Identifiers

Local EPrints ID: 419644
URI: http://eprints.soton.ac.uk/id/eprint/419644
ISSN: 2044-6055
PURE UUID: bcd10c51-5524-45ef-bb90-7c0c630dd208
ORCID for Laura Dennison: ORCID iD orcid.org/0000-0003-0122-6610
ORCID for Katherine Bradbury: ORCID iD orcid.org/0000-0001-5513-7571
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 Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 18 Apr 2018 16:30
Last modified: 17 Dec 2019 05:29

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