Abstract: SA-PO342
Perceptions of Blood Pressure, Self-Monitoring, and Self-Management among Veteran Patients with CKD: A Qualitative Study
Session Information
- Hypertension, CVD, and the Kidneys: Clinical Research
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Good, Mary K., VA Iowa City Healthcare System, Iowa City, Iowa, United States
- Ball, Daniel D., VA Iowa City Healthcare System, Iowa City, Iowa, United States
- Akbari, Sadaf, VA Iowa City Healthcare System, Iowa City, Iowa, United States
- Yamada, Masaaki, VA Iowa City Healthcare System, Iowa City, Iowa, United States
- Faro, Elissa Z., VA Iowa City Healthcare System, Iowa City, Iowa, United States
- Reisinger, Heather, VA Iowa City Healthcare System, Iowa City, Iowa, United States
- Jalal, Diana I., VA Iowa City Healthcare System, Iowa City, Iowa, United States
Background
Hypertension, commonly found in Veterans with Chronic Kidney Disease (CKD), is a well-known risk factor for CKD progression, cardiovascular disease, and mortality. As part of a project to improve blood pressure (BP) management in Veterans living with CKD, this qualitative study examines Veterans’ perceptions of BP monitoring and management.
Methods
In an ongoing clinical trial, 160 Veterans are randomized to test whether pharmacist-guided self-management of hypertension is more effective than self-monitoring and standard of care. We conducted semi-structured individual interviews covering participants’ history and knowledge of hypertension and CKD; self-monitoring routine; perceptions of BP monitoring and management; and experiences with the clinical pharmacist. Transcripts were analyzed using MAXQDA 2024 qualitative software.
Results
The team completed 37 Veteran interviews. Most respondents spoke positively about their role in monitoring BP and interactions with clinical pharmacists. Self-reports of at-home BP monitoring indicated strong adherence to study instructions. Automated reminders promoted consistency in daily BP measurement and recording despite participants’ mild irritation. Interest in tracking BP numbers varied by past experience monitoring BP, age, health literacy, and comorbidities like diabetes. Perceptions of BP measurements and trends influenced acceptability of pharmacist-guided self-management of BP. Veteran-specific factors affecting acceptability and adherence included a Commitment to Serve: Veterans hoped their participation would improve BP and CKD treatment for other Veterans in the future. Another factor was respect for Chain of Command: relationships with providers were seen through the lens of military hierarchy, with compliance interpreted as “following orders.”
Conclusion
With proper instructions and technical support, consistent, correct self-monitoring of BP appears to be feasible for Veterans with CKD. Increased education on the importance of BP management and risks of hypertension for CKD patients could help to improve Veteran adherence with home BP monitoring and overall health understanding.
Funding
- Veterans Affairs Support