Abstract
Abstract
Background
Healthy lifestyle changes for patients with stage 1 hypertension are recommended before antihypertensive medication. Exercise has antihypertensive benefits; however, low adoption and high attrition are common. Patients need easily adoptable, effective and manageable exercise interventions that can be sustained for life. We present participant and stakeholder perceptions of an isometric exercise intervention for stage 1 hypertension delivered in the National Health Service (NHS, UK).
Methods
An embedded qualitative study within a randomised-controlled feasibility study included intervention arm participants (n = 10), healthcare professionals from participating NHS sites (n = 3) and non-participating NHS sites (n = 5) taking part in semi-structured interviews to explore feasibility of delivering an isometric exercise intervention within the study design and an NHS context. Data was analysed using reflective thematic analysis.
Results
Three themes were identified: study deliverability; motivators and barriers; support for study participation. Findings indicated that the study was well designed. Health benefits, unwillingness to take medication, altruism and interest in the study helped motivation and adherence. Study support received was good, but healthcare professionals were insecure in intervention delivery with regular training/supervision needed. Perception of health improvement was mixed, but, in some, uptake of wider lifestyle changes resulted from participation. Stakeholders felt that current service challenges/demand would make implementation challenging.
Conclusions
Despite participant positivity, delivery of an isometric intervention in an NHS setting was considered challenging given the current service demand, although possible with robust effectiveness evidence. Findings support further effectiveness data and implementation development of the isometric exercise intervention.
Trial registration
ISRCTN, ISRCTN13472393. Registered 18 September 2020.
Funder
Research for Patient Benefit Programme
The Alan Squirrell Artificial Kidney Unit Trust
Publisher
Springer Science and Business Media LLC
Reference48 articles.
1. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management (NICE guideline [NG136]). 2022. https://www.nice.org.uk/guidance/ng136.
2. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–49. https://doi.org/10.1016/S0140-6736(20)30752-2.
3. NHS Digital. Health survey for England. 2021. Report website https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021-part-2/adult-health-hypertension#:~:text=The%20prevalence%20of%20hypertension%20(high,between%2027%25%20and%2028%25. Accessed 15 Aug 2023.
4. World Health Organization (WHO). Hypertension. World Health Organization; 2021. https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed 15 Aug 2023.
5. NHS England. Core20plus5 (adults) – an approach to reducing health care inequalities. https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/. Accessed 15 Aug 2023.