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Hypertension monitoring improves efficiency and supports clinical decision making in General Practice

posted 15 Aug 2016, 02:51 by Philip O'Connell   [ updated 16 Oct 2017, 03:01 by Hollie Stirman ]

Morag Hearty 
Programme Manager 

Lesley Aitken 
Programme Assistant 

Helen Alexander 
Report Compilation 

15 August 2016 

Rapid Improvement Study: 
Hypertension Monitoring in General Practice 

Many people are asked to attend their GP or Practice Nurse for the sole reason to have their blood pressure monitored and do not benefit in any other way from the visit. NHS Lanarkshire conducted a study  with the aim to asses the benefits and challenges of remotely monitoring patients' blood pressure by using  home health monitoring (HHM), with the use of a simple text messaging technology (Flo). The study involved 115 patients over a 90 day period within 14 GP practices throughout North and South Lanarkshire. 

To be able to measure the effectiveness of the study; clinical contact, clinical decision-making and patient experience were measured throughout the study period. They found the average number of contacts avoided were 4.4 due to the use of HHM, and a total of 416 appointments were avoided releasing a considerable amount of patient and clinical time. 

Clinicians were asked questions about monitoring being an aid to decision-making, those who responded agreed that it was and it helped to generate faster clinical outcomes. This was due to various reasons for example, HHM identifying 'white coat syndrome' in a third of patients that were being monitored, which may have led to mis-diagnosis of hypertension, however it also confirmed the condition in 16 patients. As well as this clinicians were able to adjust medication dosage accordingly or avoided the need for medication at all. 

Further explanation of supported clinical decision-making 

To measure patient experience the 115 participants of the study were sent a series of text messages asking about their experience with Flo. From the people who responded it was found that the majority felt Flo was easy to use, with only one patient having any difficulty using the text messaging software. 

Text responses to whether or not people found Flo easy to use

They were also asked whether or not Flo helped monitor their blood pressure. Most of the people who responded to this question found Flo helped a lot with only 1 feeling that it made no difference to them. 

Text responses to whether or not Flo helped monitor Blood Pressure 

Finally patients were asked about their willingness to use Flo again in the future, out of those who replied, only 1 person said they were not willing to do so. 

Text responses about willingness to use Flo again in future

From the study NHS Lanarkshire concluded;

HHM of blood pressure improves efficiency as it reduces the amount of appointments needed. This then reduces clinic time for clinicians including contact over the phone and prevents patient travel for routine monitoring. 

HHM of blood pressure supports clinical decision-making as it enables faster decision-making by providing optimum readings.

People mostly find it easy to monitor their own blood pressure and report results by text and would use it again in future if needed.