Table 1.
HOME BP intervention procedures for prescribers and supporters
| Practitioner | Target behaviour | Description |
|---|---|---|
| Prescriber | Planning medication escalations | At a baseline consultation, prescribers planned three potential consecutive medication escalations which they would initiate if the patient’s average blood pressure was raised for two consecutive months during the trial. |
| Changing medication in response to recommendations |
When patients’ average blood pressure readings were above-target for two consecutive months, prescribers received an automated email recommending they make the next planned medication escalation (Additional file 2). When patients had a one-off very high or very low reading, the automated email recommended a clinical review. The patient could email their prescriber via the intervention in the case of raised blood pressure readings or after a recent medication escalation. Prescribers could reply to patients via email using the HOME BP programme. |
|
| Notifying patient of medication escalation via remote communication | A template letter was provided for practitioners to send patients, asking them to pick up the prescription. | |
| Supporter | Providing remote support |
Supporters were prompted by automated email to send monthly support emails to patients using pre-written templates (Additional file 3). These templates were designed to keep patients motivated to continue self-monitoring their blood pressure and engaging in any healthy lifestyle changes (an optional add-on). Supporters could also send ad hoc emails to patients. These could be supporter-initiated (e.g. congratulating them on well-controlled readings or asking about a new medication) or patient-initiated (e.g. to respond to emails sent from patients via HOME BP using the ‘Ask the Nurse’ function). |
| Providing in-person support using the CARE approach | In-person support was designed to be minimal, but patients were offered optional appointments to help learn how to use the blood pressure monitor, and to support them in choosing a healthy lifestyle change. |