Remote blood pressure monitoring

Healthwatch Hampshire used a combination of a patient survey and in-depth interviews to understand people’s experiences of home monitoring. They collected the data from August to October 2021. Analysis is based on 179 survey responses and seven in-depth interviews. 90% of respondents were white British and in the age range 50-80 (men and women equally represented). There was low participation from black, Asian and minority ethnic groups.

Findings:

• The majority (105 - 57%) of respondents bought a monitor on their own initiative and in response to their personal concerns and experiences, e.g. the loss of a close relative at a relatively early age, a family history of hypertension, and, importantly, on the advice of their GP/consultant (41 - 23%).
• A significant number of respondents (48 - 30%) reported feeling 'safer', and 'empowered' (in control).
• Some people needed support to use a monitor. Others preferred to have their blood pressure taken at their GP practice, although reference was made by some to 'white coat syndrome', i.e. raised blood pressure when in the GP practice.
• Most people kept a record of their blood pressure readings. However, the majority of respondents 56 - 41%) did not contact their GP since acquiring a monitor, or report their practice contacting them.

Overall the survey results are inconclusive when it comes to defining a) how willing patients are to share their BP readings, and b) how readings are communicated to GP practices. In terms of the latter, the survey found a wide variation in the submission method, possibly reflecting the complexity of the health system itself, as suggested by one patient:' by hand at face-to-face reviews, else by post to the hospital consultant, when my review is by 'phone'. 88% of respondents (37/42) found the blood pressure monitor easy to use and convenient. However, many (38% - 42/137) also reported a low level of support and guidance from their local GP practice. (Where the patient had been specifically given or advised to purchase a monitor by the practice, the level of support from the practice was significantly higher, as would be expected).

Recommendations:

• Primary care providers to review and potentially enhance support to people who monitor their blood pressure at home.
• NHSX to develop and promote a mobile ‘remote monitoring’ app that people can use to record blood pressure and other lifestyle monitoring data.
• Build on the knowledge gained from this research to ensure equality of access to monitors, guidance and support, focusing on seldom-heard communities in Hampshire.