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Patient Experiences With Blood Pressure Measurement Methods for Hypertension Diagnosis: Qualitative Findings From the BP-CHECK Study.

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Title: Patient Experiences With Blood Pressure Measurement Methods for Hypertension Diagnosis: Qualitative Findings From the BP-CHECK Study.
Authors: Hansell, Laurel D, Hsu, Clarissa W, Munson, Sean A, Margolis, Karen L, Thompson, Matthew J, Ehrlich, Kelly J, Hall, Yoshio N, Anderson, Melissa L, Evers, Sarah C, Marcus-Smith, Miriam S, McClure, Jennifer B, Green, Beverly B
Source: American Journal of Hypertension; Nov2024, Vol. 37 Issue 11, p868-875, 8p
Subject Terms: AMBULATORY blood pressure monitoring, MEDICAL care, CLINICAL trial registries, PATIENTS' attitudes, PATIENT experience
Abstract: BACKGROUND Out-of-office blood pressure (BP) measurement is recommended when making a new hypertension diagnosis. In practice, however, hypertension is primarily diagnosed using clinic BP. The study objective was to understand patient attitudes about accuracy and patient-centeredness regarding hypertension diagnostic methods. METHODS Qualitative study within a randomized controlled diagnostic study conducted between May 2017 and March 2019 comparing the accuracy and acceptability of BP measurement methods among patients in an integrated healthcare delivery system. All participants completed 24-hour ambulatory blood pressure monitoring (ABPM), plus either clinic BP, home BP monitoring (HBPM), or kiosk BP diagnostic testing. Qualitative interviewees (aged 31–76 years, n  = 35) were recruited from the main study. RESULTS Participants who completed HBPM found it to be comfortable and low burden, and believed it produced accurate results. Participants in the clinic arm described clinic measurements as inconvenient. Participants in the kiosk arm overall did not favor kiosks due to concerns about accuracy and privacy. Participants described ABPM as the most accurate method due to repeated measurements over the 24-hour period in real-world contexts, but many found it uncomfortable and disruptive. Participants also noted methods that involved repeated measures such as HBPM and ABPM particularly influenced their understanding of whether or not they had hypertension. CONCLUSIONS Hypertension diagnostic methods that include more BP measurements help patients gain a deeper understanding of BP variability and the lower reliability of infrequent measurements in the clinic. These findings warrant implementing strategies to enhance out-of-office BP diagnostic testing in primary care. CLINICAL TRIALS REGISTRATION Trial number NCT03130257. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Hypertension is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Patient Experiences With Blood Pressure Measurement Methods for Hypertension Diagnosis: Qualitative Findings From the BP-CHECK Study.
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  Data: American Journal of Hypertension; Nov2024, Vol. 37 Issue 11, p868-875, 8p
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  Data: <searchLink fieldCode="DE" term="%22AMBULATORY+blood+pressure+monitoring%22">AMBULATORY blood pressure monitoring</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+care%22">MEDICAL care</searchLink><br /><searchLink fieldCode="DE" term="%22CLINICAL+trial+registries%22">CLINICAL trial registries</searchLink><br /><searchLink fieldCode="DE" term="%22PATIENTS'+attitudes%22">PATIENTS' attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22PATIENT+experience%22">PATIENT experience</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND Out-of-office blood pressure (BP) measurement is recommended when making a new hypertension diagnosis. In practice, however, hypertension is primarily diagnosed using clinic BP. The study objective was to understand patient attitudes about accuracy and patient-centeredness regarding hypertension diagnostic methods. METHODS Qualitative study within a randomized controlled diagnostic study conducted between May 2017 and March 2019 comparing the accuracy and acceptability of BP measurement methods among patients in an integrated healthcare delivery system. All participants completed 24-hour ambulatory blood pressure monitoring (ABPM), plus either clinic BP, home BP monitoring (HBPM), or kiosk BP diagnostic testing. Qualitative interviewees (aged 31–76 years, n  = 35) were recruited from the main study. RESULTS Participants who completed HBPM found it to be comfortable and low burden, and believed it produced accurate results. Participants in the clinic arm described clinic measurements as inconvenient. Participants in the kiosk arm overall did not favor kiosks due to concerns about accuracy and privacy. Participants described ABPM as the most accurate method due to repeated measurements over the 24-hour period in real-world contexts, but many found it uncomfortable and disruptive. Participants also noted methods that involved repeated measures such as HBPM and ABPM particularly influenced their understanding of whether or not they had hypertension. CONCLUSIONS Hypertension diagnostic methods that include more BP measurements help patients gain a deeper understanding of BP variability and the lower reliability of infrequent measurements in the clinic. These findings warrant implementing strategies to enhance out-of-office BP diagnostic testing in primary care. CLINICAL TRIALS REGISTRATION Trial number NCT03130257. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of American Journal of Hypertension is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1093/ajh/hpae088
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      – Code: eng
        Text: English
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        PageCount: 8
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      – SubjectFull: AMBULATORY blood pressure monitoring
        Type: general
      – SubjectFull: MEDICAL care
        Type: general
      – SubjectFull: CLINICAL trial registries
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      – SubjectFull: PATIENTS' attitudes
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              M: 11
              Text: Nov2024
              Type: published
              Y: 2024
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