The Dufftown Hypertension Project
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Abstract
Background: In 2008 we presented “e-health in a Remote and Rural Setting in the North of Scotland - An Evolving Success Storyâ€. Health models must move from treatment to prevention and self care, if health care is to meet the needs of everyone and be free at the point of delivery (NHS Core Principles). E-health has a role to play in delivering this agenda.
Because of its rural character, the region of Moray has several isolated communities. Dufftown (population 1454) is one such community; not only is it the malt whisky capital of the world but it is the first to pilot www.health-e-space.com’s self blood pressure monitoring functionality. Dufftown is an ideal “Petri dish†to trial new methods of delivering health care, to test whether they motivate, empower and engage patients in taking control of their own health and whether or not they reduce the need to see their physician and thus save on personal and professional time. Hypertension is one of the risk factors for heart disease, stroke and other long term conditions. Reduction in blood pressure (BP) reduces risk. Health professional review is important, but can cause false positives (white coat hypertension) and be expensive in time and unnecessary medication.
Objectives: This study aims to investigate the feasibility of self monitoring of BP with “electronic†General Practitioner contact. The study also aims to investigate patient empowerment and engagement.
Method: The project comprised 3 phases. Phase 1 involved a review of patients’ previous BP readings and collection of baseline measures. In Phase 2 patients received training in Omron electronic sphygmomanometers to home self monitor BP and return their machines to the practice for download at an agreed frequency. Written feedback was given. Phase 3 involved self monitoring of BP with electronic download and feedback via a bespoke website for blood pressure management with links to health tools. Participants with established hypertension, aged between 40 to 60 years with access to the internet were invited to participate.
Results: 50 people were recruited, 33 completed. Results from Phase 2 of the project have shown that BP has improved or been maintained in 70% of patients. At a group level, results revealed no statistically significant differences between baseline BP and Phase 2 BP readings (p=0.486). 76% of patients completed an evaluation of Phase 2. All patients agreed that they feel more responsible for their BP and that this method of hypertension monitoring is more convenient. Phase 3 will be completed in October and results will be available for presentation.
Conclusions: Self care BP management appears to have advantages over traditional care by empowering and promoting healthy living and saving on consultation. The population under investigation appear to be receptive to this innovation. Preliminary analysis suggests that this is a safe innovation in terms of recording of serial BP readings and final conclusions will be drawn based upon the results derived from the statistical analysis of Phase 3 and discussed within the wider context of hypertension research and health management.
Because of its rural character, the region of Moray has several isolated communities. Dufftown (population 1454) is one such community; not only is it the malt whisky capital of the world but it is the first to pilot www.health-e-space.com’s self blood pressure monitoring functionality. Dufftown is an ideal “Petri dish†to trial new methods of delivering health care, to test whether they motivate, empower and engage patients in taking control of their own health and whether or not they reduce the need to see their physician and thus save on personal and professional time. Hypertension is one of the risk factors for heart disease, stroke and other long term conditions. Reduction in blood pressure (BP) reduces risk. Health professional review is important, but can cause false positives (white coat hypertension) and be expensive in time and unnecessary medication.
Objectives: This study aims to investigate the feasibility of self monitoring of BP with “electronic†General Practitioner contact. The study also aims to investigate patient empowerment and engagement.
Method: The project comprised 3 phases. Phase 1 involved a review of patients’ previous BP readings and collection of baseline measures. In Phase 2 patients received training in Omron electronic sphygmomanometers to home self monitor BP and return their machines to the practice for download at an agreed frequency. Written feedback was given. Phase 3 involved self monitoring of BP with electronic download and feedback via a bespoke website for blood pressure management with links to health tools. Participants with established hypertension, aged between 40 to 60 years with access to the internet were invited to participate.
Results: 50 people were recruited, 33 completed. Results from Phase 2 of the project have shown that BP has improved or been maintained in 70% of patients. At a group level, results revealed no statistically significant differences between baseline BP and Phase 2 BP readings (p=0.486). 76% of patients completed an evaluation of Phase 2. All patients agreed that they feel more responsible for their BP and that this method of hypertension monitoring is more convenient. Phase 3 will be completed in October and results will be available for presentation.
Conclusions: Self care BP management appears to have advantages over traditional care by empowering and promoting healthy living and saving on consultation. The population under investigation appear to be receptive to this innovation. Preliminary analysis suggests that this is a safe innovation in terms of recording of serial BP readings and final conclusions will be drawn based upon the results derived from the statistical analysis of Phase 3 and discussed within the wider context of hypertension research and health management.
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