Thai Physicians’ Opinions about the Use of Home Blood Pressure Monitoring

Hypertension is a powerful modifiable risk factor for cardiovascular disease. The prevalence of hypertension in Thailand is increasing progressively. Patients with hypertension are usually asymptomatic, and thus proper blood pressure measurement is required to diagnose and assess the blood pressure control. Home blood pressure monitoring (HBPM) is recognized as a useful tool in hypertension management and is recommended by many organizations, including the Thai Hypertension Society. The proven benefits of HBPM beyond the usual clinic measurement is that it allowed detection of white-coat hypertension and masked hypertension, better prediction of cardiovascular events, better assessment of the status of blood pressure control, and improved treatment compliance. Despite these benefits, the use of HBPM has remained low in many countries. The Asia HBPM Survey is a collaborative study of participants from 11 countries in Asia. The present study aimed to investigate physicians’ rationale, challenge, and attitudes toward the use of HBPM for hypertensive patients. Herein, the authors report Thai physicians’ responses in the Asia HBPM Survey.

Abstract P121: Automated Messaging Program To Facilitate Systematic Home Blood Pressure Monitoring: A Qualitative Analysis Of Provider Interviews

Introduction: Hypertension is a leading cause of morbidity worldwide. Home blood pressure monitoring (HBPM) has been shown to lower blood pressure (BP) if paired with co-interventions but such programs are not routinely used in clinical care. MyBP is an automated bi-directional text messaging HBPM program that assists lowering of BP, but how to best implement within clinical care remains unknown. Therefore, in this study, we sought stakeholder input from care providers. Methods: We conducted semi-structured interviews (average recorded duration 28 minutes) with physicians, nurses, and medical assistants from primary care settings, most of whom had participated in a feasibility trial of MyBP. The interview was designed around constructs from the Consolidated Framework for Implementation Research. Interviews were transcribed verbatim and analyzed using inductive coding to organize meaningful excerpts and identify salient themes. Results: Subjects were physicians (n = 11) and nurses/medical assistants (n = 6). Care providers felt that patients benefitted from MyBP’s positive influence on BP measurement adherence, psychological factors (such as health literacy and patient empowerment), and perceived patient usability of the program. They reported that the program data aided in clinical diagnosis and management of HTN with a practical user interface for providers. Barriers to implementation included lack of integration into the electronic medical record and difficulty in training office staff in its use. Conclusion: In this qualitative analysis of care provider stakeholders, MyBP was seen as a pragmatic and effective way to empower patients in BP self-management and tangibly aid providers. Future research will need to focus on strategies to overcome implementation barriers to facilitate integration in to the clinical and digital environment.