S-58-1: PATIENT PERSPECTIVES OF A CUFFLESS BLOOD PRESSURE DEVICE COMPARED TO CLASSIC OUT-OF-CLINIC METHODS

Abstract

Objective: Wearable cuffless blood pressure (BP) monitoring technology has emerged as a novel approach to continuously measure BP for weeks and months, rather than single snapshot clinic measures that are subject to substantial variability. Given poor patient engagement with home and 24-hour BP monitoring, we explored patient attitudes toward the use of a wrist-worn cuffless device, namely the Aktiia device (Switzerland) compared to classic methods. Design and method: Two researchers conducted in-depth, semi-structured audio-recorded interviews with consecutive participants (n = 15, age 59 ± 10 years, female 33%, hypertension 100%, coronary artery disease 6.7%) recruited in Perth, Australia. They compared experiences wearing the Aktiia device for at least 7 days versus a classic 24-hour ambulatory BP monitor (Microlife WatchBP O3, Switzerland) worn on 2 separate days within 14 days. Interview topics included device acceptability, factors affecting use and hypertension awareness. Transcribed interview data were analysed thematically and interpreted. Results: There was high participant preference, acceptability and engagement with the cuffless wearable device compared to 24-hour monitoring. Classic 24-hour monitoring was associated with low acceptability, sleep disturbance and functional limitation. Despite 14/15 participants owning a home BP device, they reported infrequent use and low acceptability of classic home BP monitoring. Key determinants of cuffless technology use identified by participants were affordability, availability, comfort and usability. Participant perception on the importance of the accuracy of cuffless BP devices was variable, with responses ranging from being uncertain about the importance of accuracy to stating that a 10% margin of error was acceptable given high usability and comfort. Knowledge of the harmful effects of hypertension was poor in the population. There was universal agreement that cuffless technology could improve long-term monitoring and management of BP. Participants also agreed that cuffless technology may better engage patients and promote improved identification of high BP in society, especially if marketed with additional functions such as timekeeping and steps. Conclusions: Cuffless BP wearable devices is a rapidly emerging alternative to conventional out-of-office cuff-based BP monitoring, with great promise due to the ability for numerous unobtrusive readings. Here we report high participant preference, acceptability and engagement. However, cuffless BP device accuracy is yet to be determined with appropriate methods as cuffless device validation protocols are still under development. Given the high proportion of people with undiagnosed hypertension in the community, there is need to balance high participant acceptability and need for increased BP awareness in the community with accuracy.