Web-based system empowers patients to take active role in BP management

Use of an interactive web-based system via mobile phones has allowed patients to have a more proactive role in managing their blood pressure (BP) and thus become an expert of their BP, results of a study have shown.

“When using the system as intended, the professionals experienced it as a resource for communication regarding BP and lifestyle,” the researchers said. “Both patients and professionals described a consultation on more equal grounds, laying the foundation for a constructive partnership.”

This study employed focus group interviews with 22 patients and 15 professionals participating in a randomized controlled trial in Sweden that sought to lower BP using an interactive web-based system via mobile phones. The researchers audio-recorded and transcribed interviews and analysed the data using thematic analysis.

Three themes were identified, namely the technology, the patients, and the professional. The technology enabled participants to document BP treatment, primarily for sharing knowledge between patients and healthcare professionals. [J Med Internet Res 2021;23:e26143]

Patients, on the other hand, obtained greater knowledge of BP values and their relation to daily activities and treatment. Inspired by new insights and motivation for lifestyle changes, they were able to report about their BP treatment and thus be more responsible.

Based on patient understanding of hypertension, professionals could then use the system as an educational tool and as a new way of communicating BP treatment with patients.

However, doubts were raised regarding the use of the system: that it might be time-consuming to function in clinical practice and that too much measuring could lead to stress for some patients and an additional workload for professionals.

Moreover, not all patients and professionals had adopted the instructions on the use of the system. This could potentially result in less realization of its full potential.

“To realize the potential in a system like this, healthcare professionals need to be motivated and interested in new approaches in management of chronic conditions,” the researchers said. “Integration of the technology in the existing technical system is essential.”

In earlier studies, self-monitoring of BP enabled patients to be active and engaged in lifestyle changes, which then favoured self-management. Self-monitoring allowed patients to provide data that was previously produced by a healthcare professional at the clinical encounter. [J Hypertens 2019;37:264-279; J Med Internet Res 2016;18:e116]

Another study reported that follow-up consultations about hypertension were dominated by the healthcare professional and focused mainly on the effect of antihypertensive drugs on BP. In contrast, during follow-up consultations in the current study, the focus was more on lifestyle and its relation to BP, according to the researchers. [Pat Educ Couns 2000;40:39-49]

“To further analyse the potential benefit of using this system, future studies could focus on testing in other clinical or cultural settings such as hospital clinics with outpatient care or in other countries with a more diverse population,” the researchers said.

“As reported by Samkange-Zeeb [and colleagues], it is important to consider migration background and language competency to make information and services via the internet accessible in diverse groups,” they added. [BMC Public Health 2020;20:1263]