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Experiences, expectations and challenges of an interactive mobile phone-based system to support self-management of hypertension: patients’ and professionals’ perspectives

Authors Hallberg I, Ranerup A, Bengtsson U, Kjellgren K

Received 21 November 2017

Accepted for publication 24 January 2018

Published 28 March 2018 Volume 2018:12 Pages 467—476

DOI https://doi.org/10.2147/PPA.S157658

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Inger Hallberg,1–3 Agneta Ranerup,3,4 Ulrika Bengtsson,1,3 Karin Kjellgren1–3

1Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden; 2Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; 3Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden; 4Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden

Background:
A well-controlled blood pressure (BP) reduces cardiovascular complications. Patient participation in care using technology may improve the current situation of only 13.8% of adults diagnosed with hypertension worldwide having their BP under control.
Objective: The objective of this study was to explore patients’ and professionals’ experiences of and expectations for an interactive mobile phone-based system to support self-management of hypertension.
Methods: The self-management system consists of: 1) a mobile phone platform for self-reports, motivational messages and reminders; 2) a device for measuring BP and 3) graphical feedback of self-reports. Patients diagnosed with high BP (n=20) and their treating professionals (n=7) participated in semi-structured interviews, after 8 weeks use of the system in clinical practice. Data were analyzed thematically.
Results: The self-reporting of BP, symptoms, medication use, medication side effects, lifestyle and well-being was perceived to offer insight into how daily life activities influenced BP and helped motivate a healthy lifestyle. Taking increased responsibility as a patient, by understanding factors affecting one’s well-being, was reported as an enabling factor for a more effective care. Based on the experiences, some challenges were mentioned: for adoption of the system into clinical practice, professionals’ educational role should be extended and there should be a reorganization of care to fully benefit from technology. The patients and professionals gave examples of further improvements to the system, for example, related to the visualization of graphs from self-reports and an integration of the system into the general technical infrastructure. These challenges are important on the path to accomplishing adoption.
Conclusion: The potential of a more autonomous, knowledgeable and active patient, through use of the interactive mobile system would improve outcomes of hypertension treatment, which has been desired for decades. Documentation and visualization of patients’ self-reports and the possibilities to communicate these with professionals may be a significant resource for person-centered care.

Keywords: adherence, adoption, blood pressure, cellular phone, mHealth, person-centered care

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