Abstract：
BACKGROUND: Remote patient monitoring (RPM), which includes out-of-office blood pressure (BP) measurement, coupled with interventions including telehealth and team-based care, is recommended for hypertension (HTN) management. We aimed to assess participant experience with RPM for HTN (RPM-HTN) to understand barriers and facilitators to implementing RPM-HTN in a primary care population where health disparities and social inequities are prevalent.
METHODS: This is a qualitative implementation study of participants\' experiences with an RPM-HTN program for primary care patients with uncontrolled HTN at an academic health system. We recruited participants with high and low levels of engagement (≥16 or <16 days of transmitted BP readings per month). Semi-structured interviews were conducted, and descriptive statistics and rapid qualitative analysis were used to identify factors affecting the implementation of RPM-HTN, specifically adoption, acceptability, appropriateness, and feasibility.
RESULTS: Multiple themes emerged from interviews with 14 participants. A doctor\'s recommendation and wanting help with BP management were facilitators for engagement, while work conflicts and forgetfulness were barriers to engagement. Participants enjoyed the format and content of nurse and clinical pharmacist phone calls and forming a relationship with the team; expressed improved understanding of HTN and BP management; and appreciated the convenience of remote monitoring.
CONCLUSIONS: Participants found RPM-HTN acceptable and appropriate, highlighting the team-based and out-of-office approach to care. This study provides actionable targets to overcome feasibility barriers to implementation. In order to increase engagement, RPM policies and procedures should take into account barriers including the quantity of required BP measurements and mechanisms of telehealth communication.
METHODS: This is a qualitative implementation study of participants\' experiences with an RPM-HTN program for primary care patients with uncontrolled HTN at an academic health system. We recruited participants with high and low levels of engagement (≥16 or <16 days of transmitted BP readings per month). Semi-structured interviews were conducted, and descriptive statistics and rapid qualitative analysis were used to identify factors affecting the implementation of RPM-HTN, specifically adoption, acceptability, appropriateness, and feasibility.
RESULTS: Multiple themes emerged from interviews with 14 participants. A doctor\'s recommendation and wanting help with BP management were facilitators for engagement, while work conflicts and forgetfulness were barriers to engagement. Participants enjoyed the format and content of nurse and clinical pharmacist phone calls and forming a relationship with the team; expressed improved understanding of HTN and BP management; and appreciated the convenience of remote monitoring.
CONCLUSIONS: Participants found RPM-HTN acceptable and appropriate, highlighting the team-based and out-of-office approach to care. This study provides actionable targets to overcome feasibility barriers to implementation. In order to increase engagement, RPM policies and procedures should take into account barriers including the quantity of required BP measurements and mechanisms of telehealth communication.
摘要：
背景：远程患者监护（RPM），其中包括不在办公室的血压（BP）测量，再加上包括远程医疗和团队护理在内的干预措施，建议用于高血压（HTN）管理。我们旨在评估参与者使用RPMforHTN（RPM-HTN）的经验，以了解在健康差异和社会不平等普遍存在的初级保健人群中实施RPM-HTN的障碍和促进者。
方法：这是一项定性的实施研究，研究参与者在学术卫生系统中对患有不受控制的HTN的初级保健患者的RPM-HTN计划的经验。我们招募了参与程度高和低的参与者（每月传播的BP读数≥16天或<16天）。进行了半结构化访谈，并通过描述性统计和快速定性分析来识别影响RPM-HTN实施的因素，特别是收养，可接受性,适当性，和可行性。
结果：对14名参与者的访谈产生了多个主题。医生的建议和希望帮助BP管理是参与的促进者，而工作冲突和健忘是参与的障碍。参与者喜欢护士和临床药师电话的形式和内容，并与团队建立了关系；表达了对HTN和BP管理的理解；并赞赏远程监控的便利性。
结论：参与者发现RPM-HTN可以接受且适当，强调基于团队和外出的护理方法。这项研究提供了可行的目标，以克服实施的可行性障碍。为了增加参与度，RPM政策和程序应考虑障碍，包括所需BP测量的数量和远程医疗通信机制。
方法：这是一项定性的实施研究，研究参与者在学术卫生系统中对患有不受控制的HTN的初级保健患者的RPM-HTN计划的经验。我们招募了参与程度高和低的参与者（每月传播的BP读数≥16天或<16天）。进行了半结构化访谈，并通过描述性统计和快速定性分析来识别影响RPM-HTN实施的因素，特别是收养，可接受性,适当性，和可行性。
结果：对14名参与者的访谈产生了多个主题。医生的建议和希望帮助BP管理是参与的促进者，而工作冲突和健忘是参与的障碍。参与者喜欢护士和临床药师电话的形式和内容，并与团队建立了关系；表达了对HTN和BP管理的理解；并赞赏远程监控的便利性。
结论：参与者发现RPM-HTN可以接受且适当，强调基于团队和外出的护理方法。这项研究提供了可行的目标，以克服实施的可行性障碍。为了增加参与度，RPM政策和程序应考虑障碍，包括所需BP测量的数量和远程医疗通信机制。
