Abstract P318: English and Spanish-Speaking Patient Preferences on Home Blood Pressure Monitors: A Qualitative Study in an Urban Safety Net Setting

Abstract

Background: Self-measured blood pressure (SMBP) monitoring improves hypertension (HTN) control. Adoption of SMBP monitoring is lower among low-income or minoritized patients, who have higher rates of uncontrolled HTN. Little is known about these patients’ preferences for or challenges with SMBP monitoring. Objective: We explored patient perspectives on SMBP monitoring among patients receiving care at an urban safety-net system. Methods: We interviewed English and Spanish-speaking patients with HTN about preferences for different BP monitoring devices and their accompanying mobile apps, past experiences sharing BP data with their clinical care team, and knowledge about home BP monitoring. Interviews were conducted in the participants’ preferred language. We also asked participants to demonstrate a home BP measurement to evaluate their measurement technique. We presented two BP monitoring devices: a Bluetooth-enabled device and a cellular-enabled device. Rapid qualitative data analysis was used to analyze data. Results: Of the 15 participants (8 English-speaking; 7 Spanish-speaking), eight identified as Latine, four as Black or African American, one as American Indian/Native American, one as Asian/Pacific Islander, and one as multi-ethnic. Highest educational attainment varied: five less than high school, five high school/GED, and five college. Most required assistance with Bluetooth pairing to share data and navigating app features. All participants valued tracking their BP and were motivated to engage in SMBP monitoring but desired more training. Nearly all participants demonstrated inadequate BP knowledge and incorrect BP measurement techniques based on AHA/AMA recommendations. Few reported receiving training on SMBP monitoring techniques. Spanish speakers reported that using apps was challenging due to language discordance and wanted translated apps and resources. Costs related to device features were a key factor in preferences. Conclusions: Patient-reported barriers to SMBP adoption include cost, insufficient training, digital exclusion, and language discordance. Addressing these challenges may increase adoption of SMBP monitoring in safety-net populations. Clinicians should consider patients’ preferences when recommending SMBP monitoring. Cellular SMBP devices that automatically transmit BP readings may mitigate challenges with digital literacy and promote data sharing with clinical care teams, though future studies are needed to evaluate usability.