Patients' experiences and opinions of home blood pressure measurement

Regular measurement of the blood pressure (BP) is necessary to monitor the treatment of hypertension, and self-measurement is one technique of obtaining such measurements. The aim of this study was to investigate the experiences of individuals who have carried out home BP measurement. A qualitative method using semistructured interviews was used with 13 subjects. These were adults with hypertension who had previous experience of measuring their own BP, and were recruited to the study from one UK general medical practice. Interviews were recorded and transcribed, and data from the interviews have been analysed using phenomenological principles and identifying 'meaning units.' The findings suggest that participants were willing to carry out home measurements and several were pleased to have been asked to be more involved in their own management. All found the technique straightforward. Most noted marked variability in the day-to-day BP measurements. Several exhibited the 'white coat' phenomenon (spuriously raised BP in certain settings only). Some participants showed considerable know-ledge of hypertension and its consequences. They reported being aware of their own BP level and whether this was within acceptable limits. They also reported being willing to take further measurements, and to consider adjusting their treatment in the light of these measurements. Other participants showed less knowledge and enthusiasm, and considered the management of hypertension to be the doctor's job. The findings suggest that for some individuals home BP measurement is acceptable. They also help to explain why, for some individuals, it is not. Using the findings, a number of changes to current practice could be made, which might make home measurements more acceptable and easier to perform. As a result, a new proforma for use in everyday practice has been designed. The study shows that there is considerable scope for sharing BP measurement and management decisions in hypertension with patients themselves.