Understanding how primary care practitioners perceive an online intervention for the management of hypertension

Bradbury, Katherine; Morton, Katherine; Band, Becky; May, Carl; McManus, Richard; Little, Paul; Yardley, Lucy

doi:10.1186/s12911-016-0397-x

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Understanding how primary care practitioners perceive an online intervention for the management of hypertension

Katherine Bradbury

, Katherine Morton, Becky Band

, Carl May, Richard McManus, Paul Little, Lucy Yardley

BMC Medical Informatics and Decision Making, Volume: 17, Issue: 1

Swansea University Author: Becky Band

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DOI (Published version): 10.1186/s12911-016-0397-x

Abstract

BackgroundIn order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation....

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Published in:	BMC Medical Informatics and Decision Making
ISSN:	1472-6947
Published:	Springer Science and Business Media LLC 2017
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URI:	https://cronfa.swan.ac.uk/Record/cronfa67038
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This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP).MethodsOur Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures. We took an iterative approach moving between data collection, analysis and modifications to the HOME BP intervention, followed by further data collection. The data was analysed using thematic analysis.ResultsMany aspects of HOME BP appeared to be acceptable, persuasive and feasible to implement. Practitioners perceived benefits in using HOME BP, including that it could empower patients to self-manage their health, potentially overcome clinical inertia around prescribing medication and save both the patient and practitioner time. However, practitioners also had some concerns. Some practitioners were concerned about the accuracy of patients’ home blood pressure readings, or the potential for home monitoring to cause patients anxiety and therefore increase consultations. Some GPs lacked confidence in choosing multiple medication changes, or had concerns about unanticipated drug interactions. A few nurses were concerned that the model of patient support they were asked to provide was not consistent with their perceived role. Modifications were made to the intervention based on this feedback, which appeared to help overcome practitioners’ concerns and improve the acceptability and feasibility of the intervention.ConclusionsThis paper provides a detailed example of using the Person-Based Approach to refine HOME BP, demonstrating how we improved the acceptability and feasibility of HOME BP based on feedback from practice staff. 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The funder was not involved in the design of the study, data collection, analysis, interpretation of data or writing of the manuscript.</funders><projectreference/><lastEdited>2024-09-02T13:08:40.6102897</lastEdited><Created>2024-07-09T15:25:44.2684242</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Psychology</level></path><authors><author><firstname>Katherine</firstname><surname>Bradbury</surname><orcid>0000-0001-5513-7571</orcid><order>1</order></author><author><firstname>Katherine</firstname><surname>Morton</surname><order>2</order></author><author><firstname>Becky</firstname><surname>Band</surname><orcid>0000-0001-5403-1708</orcid><order>3</order></author><author><firstname>Carl</firstname><surname>May</surname><order>4</order></author><author><firstname>Richard</firstname><surname>McManus</surname><order>5</order></author><author><firstname>Paul</firstname><surname>Little</surname><order>6</order></author><author><firstname>Lucy</firstname><surname>Yardley</surname><order>7</order></author></authors><documents><document><filename>67038__31216__9b1c58c678b84434968dcbfdb4ce3066.pdf</filename><originalFilename>67038.VoR.pdf</originalFilename><uploaded>2024-09-02T13:07:31.5053183</uploaded><type>Output</type><contentLength>483176</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s) 2017. 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spelling	v2 67038 2024-07-09 Understanding how primary care practitioners perceive an online intervention for the management of hypertension 06b53a31f254b004de8649a376ce2fbd 0000-0001-5403-1708 Becky Band Becky Band true false 2024-07-09 HSOC BackgroundIn order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP).MethodsOur Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures. We took an iterative approach moving between data collection, analysis and modifications to the HOME BP intervention, followed by further data collection. The data was analysed using thematic analysis.ResultsMany aspects of HOME BP appeared to be acceptable, persuasive and feasible to implement. Practitioners perceived benefits in using HOME BP, including that it could empower patients to self-manage their health, potentially overcome clinical inertia around prescribing medication and save both the patient and practitioner time. However, practitioners also had some concerns. Some practitioners were concerned about the accuracy of patients’ home blood pressure readings, or the potential for home monitoring to cause patients anxiety and therefore increase consultations. Some GPs lacked confidence in choosing multiple medication changes, or had concerns about unanticipated drug interactions. A few nurses were concerned that the model of patient support they were asked to provide was not consistent with their perceived role. Modifications were made to the intervention based on this feedback, which appeared to help overcome practitioners’ concerns and improve the acceptability and feasibility of the intervention.ConclusionsThis paper provides a detailed example of using the Person-Based Approach to refine HOME BP, demonstrating how we improved the acceptability and feasibility of HOME BP based on feedback from practice staff. This demonstration may be useful to others developing digital interventions. Journal Article BMC Medical Informatics and Decision Making 17 1 Springer Science and Business Media LLC 1472-6947 Person-based approach; Qualitative research; Intervention development; Hypertension 9 1 2017 2017-01-09 10.1186/s12911-016-0397-x COLLEGE NANME Health and Social Care School COLLEGE CODE HSOC Swansea University This research was funded by the National Institute of Health Research. The funder was not involved in the design of the study, data collection, analysis, interpretation of data or writing of the manuscript. 2024-09-02T13:08:40.6102897 2024-07-09T15:25:44.2684242 Faculty of Medicine, Health and Life Sciences School of Psychology Katherine Bradbury 0000-0001-5513-7571 1 Katherine Morton 2 Becky Band 0000-0001-5403-1708 3 Carl May 4 Richard McManus 5 Paul Little 6 Lucy Yardley 7 67038__31216__9b1c58c678b84434968dcbfdb4ce3066.pdf 67038.VoR.pdf 2024-09-02T13:07:31.5053183 Output 483176 application/pdf Version of Record true © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title	Understanding how primary care practitioners perceive an online intervention for the management of hypertension
spellingShingle	Understanding how primary care practitioners perceive an online intervention for the management of hypertension Becky Band
title_short	Understanding how primary care practitioners perceive an online intervention for the management of hypertension
title_full	Understanding how primary care practitioners perceive an online intervention for the management of hypertension
title_fullStr	Understanding how primary care practitioners perceive an online intervention for the management of hypertension
title_full_unstemmed	Understanding how primary care practitioners perceive an online intervention for the management of hypertension
title_sort	Understanding how primary care practitioners perceive an online intervention for the management of hypertension
author_id_str_mv	06b53a31f254b004de8649a376ce2fbd
author_id_fullname_str_mv	06b53a31f254b004de8649a376ce2fbd_***_Becky Band
author	Becky Band
author2	Katherine Bradbury Katherine Morton Becky Band Carl May Richard McManus Paul Little Lucy Yardley
format	Journal article
container_title	BMC Medical Informatics and Decision Making
container_volume	17
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publishDate	2017
institution	Swansea University
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doi_str_mv	10.1186/s12911-016-0397-x
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description	BackgroundIn order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP).MethodsOur Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures. We took an iterative approach moving between data collection, analysis and modifications to the HOME BP intervention, followed by further data collection. The data was analysed using thematic analysis.ResultsMany aspects of HOME BP appeared to be acceptable, persuasive and feasible to implement. Practitioners perceived benefits in using HOME BP, including that it could empower patients to self-manage their health, potentially overcome clinical inertia around prescribing medication and save both the patient and practitioner time. However, practitioners also had some concerns. Some practitioners were concerned about the accuracy of patients’ home blood pressure readings, or the potential for home monitoring to cause patients anxiety and therefore increase consultations. Some GPs lacked confidence in choosing multiple medication changes, or had concerns about unanticipated drug interactions. A few nurses were concerned that the model of patient support they were asked to provide was not consistent with their perceived role. Modifications were made to the intervention based on this feedback, which appeared to help overcome practitioners’ concerns and improve the acceptability and feasibility of the intervention.ConclusionsThis paper provides a detailed example of using the Person-Based Approach to refine HOME BP, demonstrating how we improved the acceptability and feasibility of HOME BP based on feedback from practice staff. This demonstration may be useful to others developing digital interventions.
published_date	2017-01-09T13:08:39Z
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Understanding how primary care practitioners perceive an online intervention for the management of hypertension

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