BACKGROUND
Hypertension is the most prevalent and important risk factor for cardiovascular disease, affecting nearly 50% of the United States (US) adult population; however, only 30% of these patients achieve controlled blood pressure (BP). Incorporating strategies into primary care that take into consideration individual patient needs such as remote BP monitoring may improve hypertension management.
OBJECTIVE
The Stanford Precision Health pilot, Humanwide, aimed to leverage high-tech and high-touch medicine to tailor individualized care for conditions such as hypertension. We examined multi-stakeholder perceptions of hypertension management in Humanwide to evaluate the program’s acceptability, appropriateness, feasibility, and sustainability.
METHODS
We conducted semi-structured interviews with 16 patients and 15 providers to assess their experiences with hypertension management in Humanwide. We transcribed and analyzed interviews using a hybrid approach of inductive and deductive analysis to identify common themes around hypertension management and consensus methods to ensure reliability and validity.
RESULTS
Ten patients and six providers mentioned hypertension in the context of Humanwide. These participants reported remote BP monitoring improving motivation, BP control, and clinic efficiency. Providers discussed feasibility challenges including time needed to analyze BP data and give individualized feedback, integration of BP data, technological difficulties with the BP cuff, and decreased use of remote BP monitoring over time.
CONCLUSIONS
Remote BP monitoring for hypertension management in Humanwide was acceptable to patients and providers, and appropriate for care. Important challenges need to be addressed to improve the feasibility and sustainability of this approach by leveraging team-based care, engaging patients to sustain remote BP monitoring, standardizing EMR integration of BP measurements, and finding more user-friendly BP cuffs.
CLINICALTRIAL
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