A pilot study of electronic blood pressure interpretation of home blood pressure readings in primary care.

BACKGROUND: Home blood pressure (BP) monitoring is an acceptable method with high accuracy and acceptability amongst patients. It has the potential to save many hours of clinical time and is less likely to suffer from white coat bias. However, it can raise anxiety in patients who may not interpret readings immediately. AIM: A pilot study using an auto formatted excel spreadsheet which gave instantaneous colour coded feedback was sent to patients to assess its acceptability. METHOD: This auto interpretation tool was sent to patients with their consent. It enabled patients to receive immediate feedback about this blood pressure control. A follow-up questionnaire was later sent to ask the patients and the staff about their experience. RESULTS: Hypertensive patients under 75 years of age who were sending regular home BP readings were enrolled (n = 96); of these, 31 responded within 1 month. Patient satisfaction was high; 74% preferred the electronic tool, 77% found the colour indicator reassuring, and 87% wanted to continue the electronic interpretation tool regardless of their initial preference. Staff satisfaction was excellent at 100%. CONCLUSION: This hypertension triage tool allows for interpretation by patients and non-clinicians with benefits of instantaneous reassurance, user and provider satisfaction all at reduced costs. Patients without MS Excel could not use this tool. The pilot study reinforced our hypothesis that such a modality has the potential to increase patient satisfaction and safety, and can be applied to a larger number of patients. Eventually an NHS app could be developed and rolled out for the large population.

The unmet needs of menopausal women in primary care.

BACKGROUND: The average age for menopause is 51 years, this is preceded by a transitional perimenopausal stage, with vasomotor symptoms, muscular and joint pain, lowered libido and disordered sleep, impacting on mental health. In some women, the quality of life is considerably affected. This remains under-reported. There is no national screening service, or specialised clinics for menopausal services available in primary care. AIM: We undertook a survey of women in primary care as part of a needs assessment to understand the prevalence of peri- and menopausal symptoms, women's knowledge of these symptoms, and available treatment options. METHOD: A questionnaire was sent to women aged 45-65 years registered with the practice. RESULTS: Of a total of 73 women, 78.1% complained of >4 symptoms. The most common symptoms were memory problems and brain fog (80.6%), sleep disturbance (72.1%) and muscle/joint pain (72.1%). Women were asked to rate their knowledge of therapy options on a self-reported scale of 0-10; a high proportion (64.3%) rated <4 points. They had better knowledge of symptoms, 79.3% rated >4 points. A high proportion (58.9%) rated inadequate support received from primary care and 75.3% felt they had no support at all. CONCLUSION: Our results of this preliminary study showed the vast majority of women were unaware of treatment options for their menopausal symptoms and felt they received inadequate to no support from primary care providers. The present ongoing study highlights lack of resource allocation to women's health and insufficient commissioning of services to address this health need.