Al-Rousan Tala, Awad Mina, Amalia Pesantes M, Kandula Namratha R, Huffman Mark D, Jaime Miranda J, Vidal-Perez Rafael, Dzudie Anastase, Anderson Cheryl A M
Department of Medicine, University of California San Diego School of Medicine, United States.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, United States.
Prev Med Rep. 2023 Mar 17;33:102179. doi: 10.1016/j.pmedr.2023.102179. eCollection 2023 Jun.
Home blood pressure management, including self-monitoring and medication self-titration, is an efficient and cost-effective tool. Although its use is increasing globally, little is known about the feasibility of such interventions in low and middle-income countries. Further, the perspectives and experiences of healthcare providers who play a big role in ensuring the success of home blood pressure management interventions have not been documented. This qualitative study was conducted with a total of 35 healthcare providers (60% female, mean [SD] age = 37.3 [6.9 years] years), through 4 in-depth interviews from Peru, and 8 in-depth interviews and 4 focus groups from Cameroon. Study participants (healthcare providers) include physicians (primary care physicians), specialists (cardiologists and geriatricians), and nurses that were purposively recruited from two hospitals in two of the largest cities in both countries. Results were thematically analyzed by two researchers. Themes derived were related to feasibility and acceptability, and largely reflected providers in both countries endorsing home blood pressure management. Providers' concerns were in three main areas; 1) safety of patients when they self-titrate medications, 2) resources such as healthcare financing, local hospital policies that support communications with patients for home blood pressure management, and 3) sustainability through patient adherence, incorporating home blood pressure management within clinical guidelines and hospital policies, and complementing with continued health education and lifestyle modifications. According to providers, home blood pressure management may be feasible and acceptable if tailored multi-faceted protocols were introduced bearing in mind local contexts.
家庭血压管理，包括自我监测和药物自我滴定，是一种高效且具有成本效益的工具。尽管其在全球的使用正在增加，但对于低收入和中等收入国家此类干预措施的可行性知之甚少。此外，在确保家庭血压管理干预措施成功方面发挥重要作用的医疗保健提供者的观点和经验尚未得到记录。这项定性研究共对35名医疗保健提供者（60%为女性，平均[标准差]年龄 = 37.3[6.9岁]岁）进行，其中来自秘鲁的有4次深入访谈，来自喀麦隆的有8次深入访谈和4次焦点小组访谈。研究参与者（医疗保健提供者）包括医生（初级保健医生）、专家（心脏病专家和老年病专家）以及护士，他们是从两国两个最大城市的两家医院中特意招募的。两名研究人员对结果进行了主题分析。得出的主题与可行性和可接受性相关，并且在很大程度上反映了两国的提供者都认可家庭血压管理。提供者的担忧主要集中在三个方面：1）患者自我滴定药物时的安全性，2）资源，如医疗保健融资、支持与患者就家庭血压管理进行沟通的当地医院政策，以及3）通过患者依从性实现可持续性，将家庭血压管理纳入临床指南和医院政策，并辅以持续的健康教育和生活方式改变。据提供者称，如果在考虑当地情况的前提下引入量身定制的多方面方案，家庭血压管理可能是可行且可接受的。
