PMID- 36174484 OWN - NLM STAT- MEDLINE DCOM- 20221130 LR - 20221130 IS - 2210-7797 (Electronic) IS - 2210-7789 (Linking) VI - 30 DP - 2022 Dec TI - Perceptions and experiences of blood pressure self-monitoring during hypertensive pregnancy: A qualitative analysis of women's and clinicians' experiences in the OPTIMUM-BP trial. PG - 113-123 LID - S2210-7789(22)00099-X [pii] LID - 10.1016/j.preghy.2022.09.006 [doi] AB - BACKGROUND: Self-monitoring of blood pressure (BP) has been shown to be effective at improving BP control in the general population. The OPTIMUM-BP feasibility study was a prospective randomised controlled trial of self-monitoring of BP (SMBP) during hypertensive pregnancy. OBJECTIVE: To explore experiences, perceptions, and use of the OPTIMUM-BP self-monitoring intervention. STUDY DESIGN: Qualitative study within the OPTIMUM-BP feasibility trial. Semi-structured interviews with a purposive sample of pregnant women with chronic hypertension (n = 24) and their clinicians (n = 8) as well as 38 ethnographic observations of antenatal visits. RESULTS: Women found self-monitoring of BP feasible and acceptable and were highly motivated and pro-active in their monitoring, reporting greater control and knowledge of BP and reassurance. Women's persistence with SMBP was driven by a perceived need to safeguard the pregnancy, particularly among those taking antihypertensive medication. Clinicians also described the intervention as acceptable, though BP variability could cause uncertainty. Clinicians used different heuristics to integrate home and clinic readings. Observations suggested close working relationships between women and clinicians were key for confident integration of self-monitoring. CONCLUSIONS: Self-monitoring of BP was acceptable both to pregnant women with hypertension and their clinicians. More research is needed to understand BP variability within pregnancy to help interpret and integrate home BP readings for improved BP management. Clinical pathways that use BP self-monitoring should aim to maintain the continuity of care and relationships that are valued and appear pivotal for the confident and safe use of self-monitoring in pregnancy. CI - Copyright (c) 2022 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Pealing, L AU - Pealing L AD - Nuffield Department of Primary Care Health Sciences, University of Oxford OX2 6GG, UK. FAU - Tucker, K L AU - Tucker KL AD - Nuffield Department of Primary Care Health Sciences, University of Oxford OX2 6GG, UK. Electronic address: katherine.tucker@phc.ox.ac.uk. FAU - Fletcher, B AU - Fletcher B AD - Nuffield Department of Primary Care Health Sciences, University of Oxford OX2 6GG, UK. FAU - Lawley, E AU - Lawley E AD - Nuffield Department of Primary Care Health Sciences, University of Oxford OX2 6GG, UK. FAU - Chappell, L C AU - Chappell LC AD - Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 7EH, UK. FAU - McManus, R J AU - McManus RJ AD - Nuffield Department of Primary Care Health Sciences, University of Oxford OX2 6GG, UK. FAU - Ziebland, S AU - Ziebland S AD - Nuffield Department of Primary Care Health Sciences, University of Oxford OX2 6GG, UK. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20220920 PL - Netherlands TA - Pregnancy Hypertens JT - Pregnancy hypertension JID - 101552483 SB - IM MH - Female MH - Humans MH - Pregnancy MH - Blood Pressure MH - Blood Pressure Monitoring, Ambulatory MH - Prospective Studies MH - *Pre-Eclampsia MH - *Hypertension/drug therapy OTO - NOTNLM OT - Blood pressure OT - Ethnography OT - Hypertension OT - Pregnancy OT - Qualitative OT - Self-monitoring COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/09/30 06:00 MHDA- 2022/12/01 06:00 CRDT- 2022/09/29 18:33 PHST- 2022/04/05 00:00 [received] PHST- 2022/09/12 00:00 [revised] PHST- 2022/09/15 00:00 [accepted] PHST- 2022/09/30 06:00 [pubmed] PHST- 2022/12/01 06:00 [medline] PHST- 2022/09/29 18:33 [entrez] AID - S2210-7789(22)00099-X [pii] AID - 10.1016/j.preghy.2022.09.006 [doi] PST - ppublish SO - Pregnancy Hypertens. 2022 Dec;30:113-123. doi: 10.1016/j.preghy.2022.09.006. Epub 2022 Sep 20.