A cross-sectional survey and service evaluation of simple telehealth in primary care: what do patients think?

Abstract

ObjectiveTo determine the patient experience of using a simple telehealth strategy to manage hypertension in adults.DesignAs part of a pragmatic service evaluation, the acceptability of, satisfaction with and ease of use of a simple telehealth strategy was determined via text, cross-sectional questionnaire survey administered by telephone, case studies, discussion groups and informal feedback from practices. This simple telehealth approach required patients to take home blood pressure (BP) readings and text them to a secure server (‘Florence’) for immediate automatic analysis and individual healthcare professional review.Participants124 intervention patients who used the Florence system.Setting10 volunteer general practitioner's (GP) practices in Stoke on Trent, UK, with poor health and high levels of material deprivation took part.ResultsPatient satisfaction was high. In particular, patients found the system easy to use, were very satisfied about the feedback from their GP regarding their BP readings, found the advice sent via Florence useful and preferred to send BP readings using Florence rather than having to go to the practice monthly to get BP checked. Overall satisfaction with the system was 4.81/5.00 at week 13 of the programme. Other advantages of being enrolled with Florence were improved education about hypertension, a greater feeling of support and companionship and flexibility which allowed self-care to occur at a time that suited the patient rather than their practice.ConclusionsThis simple telehealth strategy for managing hypertension in the community was met with high levels of patient satisfaction and feelings of control and support. This management approach should thus be considered for widespread implementation for clinical management of hypertension and other long-term conditions involving monitoring of patients’ bodily measurements and symptoms as a large number of meaningful readings can be obtained from many patients in a prompt, efficient, interactive and acceptable way.

The feasibility and acceptability of self-testing for proteinuria during pregnancy: A mixed methods approach

“…A feasibility study done in lowrisk pregnant women showed a preference for blood pressure selfmonitoring with a reduced schedule of antenatal visits, and no change in anxiety levels [22]. Literature on blood pressure self-monitoring outside pregnancy indicates patients are confident at self-monitoring and report high levels of satisfaction and feelings of involvement, control, and support for their health [23,24]. In the current study similar findings for self-testing of urine are reported; women whose readings were used by HCPs felt valued and involved in their own care and reported positive experiences.…”

Are Telehealth Technologies for Hypertension Care and Self-Management Effective or Simply Risky and Costly?

“…Recent manuscripts further demonstrate the feasibility of virtual environments for educating adults with chronic illness. 62,63,64 Additionally, studies of telehealth programs show at least short-term clinical improvements for BP outcomes; such findings may be explained in part because home BP readings may be more reliable than those obtained in a physician's office because of ''white coat syndrome'' in which a patient's BP is elevated in the clinical setting, but not in other settings. As more robust studies emerge, it will be helpful to have a systematic review and/or meta-analysis conducted to show positive and negative impact of BP studies by type of intervention.…”

Implementing Home Blood Glucose and Blood Pressure Telemonitoring in Primary Care Practices for Patients with Diabetes: Lessons Learned

“…To address the need for information about telemonitoring implementation in clinical practice, we focus here on the experiences of the nurses, physicians, and patients who submitted, received, and reviewed these home BG and BP data. Previous examinations of primary care telemonitoring implementations have been limited to examinations of feasibility and acceptability, [15][16][17] a single stakeholder perspective, 15,18,19 or centralized monitoring by research personnel not well integrated with the primary practice site. [20][21][22] The clinical trial that is the background for this work was very much an effectiveness trial.…”