Patient Acceptance of Blood Pressure Self-Measurement Equipment using Context-Aware Patient Guidance

Background: Hypertensive disease and preeclampsia are serious medical disorders affecting pregnancy. Screening in early pregnancy may identify women at risk and enable prophylactic treatment. Accurate blood pressure (BP) measurement at the hospital outpatient clinic in the first trimester of pregnancy is an important part of this screening process. As the screening procedure is lengthy, lasting up to 30 minutes, an automated blood pressure self-measurement procedure could save sparse staff resources. However, patients tend to make errors when self-measuring, which could result in treatment-errors. Previous work has investigated equipping self-measurement stations with context-aware patient guidance, which is able to detect and mitigate such measurement errors, and even recover from them. The technical performance of these systems has previously been reported. Objectives: The aim of this study was to evaluate patient acceptance levels when performing self-measurements using a context-aware patient guidance system as part of a blood pressure self-measurement (BPSM) station. Methods: In an observational study, 100 pregnant women were invited to self-measure their BP using a BPSM system consisting of a clinically validated BP device, and a context-aware sensor system for registering rest-time, talking, and other relevant context parameters, seeking to improve participant adherence through interactive guidance. Acceptance of the automated self-measurement, including the interactive guidance, was evaluated using a questionnaire in a follow-up interview session immediately after the self-measurement process. Participants were also invited to provide open comments on their experience. Results: The majority of the participants, 93 %, felt comfortable using self-measurement equipment, while a minority of 8 % would have preferred staff assisted measurements. The majority of participants expressed mostly positive feelings associated with the user experience of self-measurement, with 83--88 % using positive utterances of the experience. Conclusion: We found patient acceptance levels of performing self-measurements using interactive and context-aware guidance, without staff participation, to be an overall positive experience. Suggestions on how to mitigate the negative experiences were discussed, and these should be investigated further.