TY - JOUR
AU - F. Wu
AU - S. Moriarty
AU - H. Toole
AU - J. Wherton
AU - D. Mohebbi
AU - J. P. Sheppard
AU - S. E. Shaw
AU - S. Marjanovic
A1 - 
AB - BACKGROUND: High blood pressure (BP) is a leading cause of morbidity and mortality. Blood pressure home monitoring improves blood pressure control, but there is limited evidence about the implementation of specifically 'technology-enabled' remote monitoring of blood pressure (TERM BP) at home. This evaluation aims to improve the evidence base on what constitutes TERM BP services, how they work, and what influences their implementation, impacts, spread, and scale. METHODS: A multi-method, rapid qualitative evaluation involved four sites that implemented TERM BP. Across sites, we conducted interviews with staff (n = 35) and patients (n = 15) and analyzed key service documents. Three workshops with site staff, patients, and regional and national stakeholders helped refine the learning process. Thematic analysis and synthesis, and triangulation against existing literature, helped inform recommendations and was guided by the Non-adoption, Abandonment, and challenges to Scale-up, Spread and Sustainability of the technology framework. Patient and public voices informed the evaluation design and conduct. RESULTS: TERM BP implementation varies in governance, patient eligibility, technology, workforce, and workflow. Perceived impacts include improved blood pressure control, case-finding, and a more efficient workload distribution. The parallel running of technology-enabled and paper-based pathways mitigates access inequalities, but involves a high administrative workload. Sociotechnical influences on implementation relate to technology user-friendliness and adaptability, health system relationships and resources, practice capabilities and learning cultures, and patient acceptability and enablement. Flexibility within a planned, gradual approach that embeds skills in teams and systems and impacts evidence generation support scale and spread. CONCLUSIONS: Technology and social forces co-evolve to shape TERM BP pathways and manage co-existing tensions, including planning, emergence, demand, and capacity. Decision makers should establish implementation guidance and commissioning criteria, address regulatory issues, and enable evidence generation and shared learning. Further research is needed on the impact of TERM BP, especially in integrated care and related to inequalities.; High blood pressure affects more than a quarter of the population in the UK. Managing it well can help prevent further health problems. One way to help people control high blood pressure is to use devices such as home blood pressure monitors and mobile phones. This is called technology-enabled remote monitoring of blood pressure at home. We still need to understand more about what works well when using technology-enabled remote monitoring. In this study, we looked at how, where, why, and for whom technology-enabled remote monitoring of blood pressure is used. We interviewed 35 healthcare professionals and 15 patients across four sites (for example, general practices). We held three workshops with healthcare professionals, other decision makers, and patients to discuss and refine the findings. We found that technology-enabled remote monitoring of blood pressure was used in various ways. Sometimes, the service is delivered by general practice and sometimes by staff working in a local area to support patients across many general practices. At most sites, technology-enabled remote monitoring is managed by a nurse or pharmacist instead of a general practitioner (GP). Support from a variety of clinical and non-clinical staff is important. Most patients were engaged and motivated to use technology-enabled remote monitoring, although some were concerned about whether they were using the monitors correctly. The patients also highlighted that technology-enabled remote monitoring may not be a good fit for everyone. Technology-enabled remote monitoring can support both patients and healthcare professionals in managing high blood pressure, but more research is needed to understand the wider impact (e.g., on demand for GP appointments). Decisionmakers should consider how technology-enabled remote monitoring can be gradually expanded to reach more people. Planning is needed to ensure that it is widely accessible and does not place too much extra burden on the staff.; eng
AD - RAND Europe, Cambridge, England, CB2 8BF, UK.; University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, England, OX2 6GG, UK.
AN - 42368225
BT - NIHR Open Res
C5 - HIT & Telehealth
DO - 10.3310/nihropenres.14008.2
DP - NLM
ET - 20260604
JF - NIHR Open Res
LA - eng
N2 - BACKGROUND: High blood pressure (BP) is a leading cause of morbidity and mortality. Blood pressure home monitoring improves blood pressure control, but there is limited evidence about the implementation of specifically 'technology-enabled' remote monitoring of blood pressure (TERM BP) at home. This evaluation aims to improve the evidence base on what constitutes TERM BP services, how they work, and what influences their implementation, impacts, spread, and scale. METHODS: A multi-method, rapid qualitative evaluation involved four sites that implemented TERM BP. Across sites, we conducted interviews with staff (n = 35) and patients (n = 15) and analyzed key service documents. Three workshops with site staff, patients, and regional and national stakeholders helped refine the learning process. Thematic analysis and synthesis, and triangulation against existing literature, helped inform recommendations and was guided by the Non-adoption, Abandonment, and challenges to Scale-up, Spread and Sustainability of the technology framework. Patient and public voices informed the evaluation design and conduct. RESULTS: TERM BP implementation varies in governance, patient eligibility, technology, workforce, and workflow. Perceived impacts include improved blood pressure control, case-finding, and a more efficient workload distribution. The parallel running of technology-enabled and paper-based pathways mitigates access inequalities, but involves a high administrative workload. Sociotechnical influences on implementation relate to technology user-friendliness and adaptability, health system relationships and resources, practice capabilities and learning cultures, and patient acceptability and enablement. Flexibility within a planned, gradual approach that embeds skills in teams and systems and impacts evidence generation support scale and spread. CONCLUSIONS: Technology and social forces co-evolve to shape TERM BP pathways and manage co-existing tensions, including planning, emergence, demand, and capacity. Decision makers should establish implementation guidance and commissioning criteria, address regulatory issues, and enable evidence generation and shared learning. Further research is needed on the impact of TERM BP, especially in integrated care and related to inequalities.; High blood pressure affects more than a quarter of the population in the UK. Managing it well can help prevent further health problems. One way to help people control high blood pressure is to use devices such as home blood pressure monitors and mobile phones. This is called technology-enabled remote monitoring of blood pressure at home. We still need to understand more about what works well when using technology-enabled remote monitoring. In this study, we looked at how, where, why, and for whom technology-enabled remote monitoring of blood pressure is used. We interviewed 35 healthcare professionals and 15 patients across four sites (for example, general practices). We held three workshops with healthcare professionals, other decision makers, and patients to discuss and refine the findings. We found that technology-enabled remote monitoring of blood pressure was used in various ways. Sometimes, the service is delivered by general practice and sometimes by staff working in a local area to support patients across many general practices. At most sites, technology-enabled remote monitoring is managed by a nurse or pharmacist instead of a general practitioner (GP). Support from a variety of clinical and non-clinical staff is important. Most patients were engaged and motivated to use technology-enabled remote monitoring, although some were concerned about whether they were using the monitors correctly. The patients also highlighted that technology-enabled remote monitoring may not be a good fit for everyone. Technology-enabled remote monitoring can support both patients and healthcare professionals in managing high blood pressure, but more research is needed to understand the wider impact (e.g., on demand for GP appointments). Decisionmakers should consider how technology-enabled remote monitoring can be gradually expanded to reach more people. Planning is needed to ensure that it is widely accessible and does not place too much extra burden on the staff.; eng
PY - 2025
SN - 2633-4402
SP - 81
ST - Enabling scale and spread of technology-enabled remote monitoring of blood pressure at home: findings from a rapid qualitative evaluation
T1 - Enabling scale and spread of technology-enabled remote monitoring of blood pressure at home: findings from a rapid qualitative evaluation
T2 - NIHR Open Res
TI - Enabling scale and spread of technology-enabled remote monitoring of blood pressure at home: findings from a rapid qualitative evaluation
U1 - HIT & Telehealth
U3 - 10.3310/nihropenres.14008.2
VL - 5
VO - 2633-4402
Y1 - 2025
ER -