Acceptance of Ambulatory Blood Pressure Monitoring in a Semi-rural Population in South Africa

Overview

Journal Health SA

Specialty Health Services

Date 2020 Jul 17

PMID 32670621

Authors

Farisai Chiwanza

Yoland Irwin

Ros Dowse

Affiliations

Soon will be listed here.

Abstract

Background: Ambulatory blood pressure monitoring is a valuable tool that helps in providing an insight into the diagnosis and management of hypertension; however, no evidence exists of its acceptance in the diverse South African population.

Aim: We assessed the acceptance of an ambulatory blood pressure monitor in patients attending public sector primary health care (PHC) clinics.

Setting: Five PHC clinics in the Makana subdistrict in the Eastern Cape.

Method: A cross-sectional study was conducted with 70 hypertensive patients. Eligible patients were between 40 and 75 years old, taking either enalapril and hydrochlorothiazide or enalapril, hydrochlorothiazide and amlodipine. Socio-demographic, clinical and acceptance data were collected. The monitor cuff remained in place for 24 h. Acceptance was assessed after the monitor was removed. An overall acceptance score was generated to classify acceptance as either good or poor.

Results: The mean years of schooling was 5.9 years, with 22 reporting no school attendance. Generally, acceptance was good, with 70% of the population rating the technique as 'acceptable' (acceptance score of > 23/30). Most participants reported minimal discomfort with only 13.3% reporting that it hindered normal daily activities. Night readings interrupted sleep in 43%, with extreme sleep disturbance (≥ 3 awakenings) reported in just over half the patients. Increased years of schooling was the only variable associated with acceptance score ( = -0.243, = 0.042).

Conclusion: Ambulatory blood pressure monitoring was generally well-accepted, with few adverse effects being reported. Use of this technique at PHC facilities could reduce the incidence of misdiagnosis and uncontrolled hypertension.

References

Williams S, Swanson M . The effect of reading ability and response formats on patients' abilities to respond to a patient satisfaction scale. J Contin Educ Nurs. 2002; 32(2):60-7. DOI: 10.3928/0022-0124-20010301-05. View

OBrien E . Ambulatory blood pressure monitoring in the management of hypertension. Heart. 2003; 89(5):571-6. PMC: 1767663. DOI: 10.1136/heart.89.5.571. View

Weiss B, Hart G, McGee D, DEstelle S . Health status of illiterate adults: relation between literacy and health status among persons with low literacy skills. J Am Board Fam Pract. 1992; 5(3):257-64. View

Walker S, Permezel M, Brennecke S, Tuttle L, Higgins J . Patient satisfaction with the SpaceLabs 90207 ambulatory blood pressure monitor in pregnancy. Hypertens Pregnancy. 2004; 23(3):295-301. DOI: 10.1081/PRG-200030306. View

Bygbjerg I . Double burden of noncommunicable and infectious diseases in developing countries. Science. 2012; 337(6101):1499-501. DOI: 10.1126/science.1223466. View

Addo J, Smeeth L, Leon D . Hypertension in sub-saharan Africa: a systematic review. Hypertension. 2007; 50(6):1012-8. DOI: 10.1161/HYPERTENSIONAHA.107.093336. View

DAlonzo K . Evaluation and revision of questionnaires for use among low-literacy immigrant Latinos. Rev Lat Am Enfermagem. 2011; 19(5):1255-64. PMC: 3286231. DOI: 10.1590/s0104-11692011000500025. View

Viera A, Lingley K, Hinderliter A . Tolerability of the Oscar 2 ambulatory blood pressure monitor among research participants: a cross-sectional repeated measures study. BMC Med Res Methodol. 2011; 11:59. PMC: 3097008. DOI: 10.1186/1471-2288-11-59. View

Peek S, Wouters E, van Hoof J, Luijkx K, Boeije H, Vrijhoef H . Factors influencing acceptance of technology for aging in place: a systematic review. Int J Med Inform. 2014; 83(4):235-48. DOI: 10.1016/j.ijmedinf.2014.01.004. View

10.

Pickering T, Shimbo D, Haas D . Ambulatory blood-pressure monitoring. N Engl J Med. 2006; 354(22):2368-74. DOI: 10.1056/NEJMra060433. View

11.

Friis K, Lasgaard M, Osborne R, Maindal H . Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29,473 Danish citizens. BMJ Open. 2016; 6(1):e009627. PMC: 4735217. DOI: 10.1136/bmjopen-2015-009627. View

12.

Mallion , de Gaudemaris R , Baguet , Azzouzi , Quesada , Sauzeau . Acceptability and tolerance of ambulatory blood pressure measurement in the hypertensive patient. Blood Press Monit. 1996; 1(3):197-203. View

13.

Rosendorff C, Black H, Cannon C, Gersh B, Gore J, Izzo Jr J . Treatment of hypertension in the prevention and management of ischemic heart disease: a scientific statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and.... Circulation. 2007; 115(21):2761-88. DOI: 10.1161/CIRCULATIONAHA.107.183885. View

14.

Beltman F, Heesen W, Smit A, May J, Lie K, Jong B . Acceptance and side effects of ambulatory blood pressure monitoring: evaluation of a new technology. J Hum Hypertens. 1996; 10 Suppl 3:S39-42. View

15.

Gomez-Olive F, Ali S, Made F, Kyobutungi C, Nonterah E, Micklesfield L . Regional and Sex Differences in the Prevalence and Awareness of Hypertension: An H3Africa AWI-Gen Study Across 6 Sites in Sub-Saharan Africa. Glob Heart. 2017; 12(2):81-90. PMC: 5967381. DOI: 10.1016/j.gheart.2017.01.007. View

16.

Ernst M, Bergus G . Favorable patient acceptance of ambulatory blood pressure monitoring in a primary care setting in the United States: a cross-sectional survey. BMC Fam Pract. 2003; 4:15. PMC: 270030. DOI: 10.1186/1471-2296-4-15. View

17.

Elliot L, Iqbal P . Factors associated with probability of patient rejecting a repeat 24 h ambulatory blood pressure monitoring, despite recommendation by the physician. Blood Press Monit. 2003; 8(5):191-4. DOI: 10.1097/00126097-200310000-00003. View

18.

Williams M, Parker R, Baker D, Parikh N, Pitkin K, Coates W . Inadequate functional health literacy among patients at two public hospitals. JAMA. 1995; 274(21):1677-82. View

19.

Cooper L, Hill M, Powe N . Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. J Gen Intern Med. 2002; 17(6):477-86. PMC: 1495065. DOI: 10.1046/j.1525-1497.2002.10633.x. View

20.

Lai C, Chung J, Leung N, Wong J, Mak D . A survey of older Hong Kong people's perceptions of telecommunication technologies and telecare devices. J Telemed Telecare. 2010; 16(8):441-6. DOI: 10.1258/jtt.2010.090905. View