How do patients experience and use home blood pressure monitoring? A qualitative analysis with UTAUT 2.

Background: Hypertension is an important cardiovascular risk factor with potentially harmful consequences. Home blood pressure monitoring is a promising method for following the effect of hypertension treatment. The use of technology-enabled care and increased patient involvement might contribute to more effective treatment methods. However, more knowledge is needed to explain the motivations and consequences of patients engaging in what has been called 'do-it-yourself healthcare'. Aim: This study aimed to investigate patients' experiences of home blood pressure monitoring through the theoretical frame of the Unified Theory of Acceptance and Use of Technology (UTAUT 2). Methods: The study had a qualitative design, with focus group interviews using the web-based platform Zoom. The data were analysed using qualitative deductive content analysis, inspired by Graneheim and Lundman. Results: The results are presented using the seven theoretical constructs of UTAUT 2: Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Hedonistic Motivation, Price Value and Habit. We found one overarching theme ‒ 'It's all about the feeling of security'. The patients were influenced by relatives or healthcare personnel and experienced the home monitoring process as being easy to conduct. The patients emphasised that the quality of the blood pressure monitor was more important than the price. Patients reported home monitoring of blood pressure as a feasible method to follow-up care of their hypertension. Discussion: This study indicates that among motivated patients, home blood pressure measurement entails minimal effort, increases security, and leads to better communication about blood pressure between healthcare personnel and patients.

Self-monitoring of hypertension is an increasingly common method and may increase measurement accuracy and patient involvement.Through the theoretical lens of the UTAUT2, home blood pressure monitoring seems to increase patients´ feeling of security.The respondents did not report negative experiences and might have been more prone to use technology-enabled care.Home blood pressure monitoring seems to be easily adopted by motivated patients with an interest in self-monitoring their disease.