Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 18, 2021
Open Peer Review Period: Aug 18, 2021 - Oct 13, 2021
Date Accepted: Apr 13, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Perceptions of precision health approaches in hypertension management; a quality improvement study
ABSTRACT
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. Clinical Trial: n/a
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.