Edinburgh Napier University

  Objectives
The aim of this study was to understand how patients experienced hypertension management, with or without BP telemonitoring, during the COVID-19 pandemic.

Design, Methods, participants, and setting
This qualitative study conducted between April and November 2022 consisted of 43 semi-structured telephone interviews (23 men and 20 women) from six primary care practices in one area of Scotland.

Results
From the views of 25 participants with experience of using the Connect Me telemonitoring service and 18 participants without such experience, five themes were developed. These were: (1) Navigating access to services. There were challenges to gaining timely and/or in-person access to services and a reluctance to attend clinical settings because participants were aware of their increased risk of contracting the COVID-19 virus. (2) Adapting NHS services. All six practices had adapted care provision in response to potential COVID-19 transmission, however, these adaptations disrupted routine management of in-person primary care hypertension, diabetes and/or asthma checks. (3) Telemonitoring feedback. Telemonitoring reduced the need to attend in-person primary care practices and supported access to remote healthcare monitoring and feedback. (4) Self-management. Many non-telemonitoring participants were motivated to use self-management strategies to track their blood pressure using home monitoring equipment. Also, participants were empowered to self-manage lifestyle and hypertension medication. (5) Experience of having COVID-19. Some participants contracting the COVID-19 virus experienced an immediate increase in their BP whilst a few experienced ongoing increased BP readings.

Conclusions
The COVID-19 pandemic disrupted routine in-person care for hypertension patients. Both telemonitoring and some non-telemonitoring patients were motivated to self-manage hypertension, including self-adjusting medication, however only those with access to telemonitoring had increased access to hypertension monitoring and feedback. Blood pressure telemonitoring permitted routine care to continue for participants in this study and may offer a service useful in pandemic proofing hypertension healthcare in the future.