Table 2. Focus group pre-planned questions
Attitudes towards self-monitoring
  • What proportion of your hypertensive patients do you think have or use BP monitors at home?

  • Do patients ask you what BP monitor they should buy? Do you recommend the purchase of BP monitors for home use? Do you advise patients on what kind of BP monitor to buy?

  • Do you offer patients (in general, not in the trial) information on how to take BP at home? When to take it? What to do according to the BP results?

  • Do you think that HBPM (in real life, outside the trial) contributes to better control of hypertensive patients? Does it help to reduce the 'white-coat syndrome'?

  • Do you think HBPM reduces follow-up consultations or do you think that patients take BP excessively and that HBPM generates unnecessary consultations?

  • Do you ask patients to bring their BP monitors to the healthcare centre to compare their readings with those taken in the consultation and check the calibration?

  • Do you lend BP monitors to patients? (For example, at the time of diagnosis or to have more information before changing a treatment.)

  • Do you ask patients to bring their readings to the consultation? How do you use those readings? Do you incorporate them into decision making or do you only trust the readings taken during the consultation?

Trial experience
  • How comfortable do you feel about patients having pre-specified medication change plans in advance? Does it produce a higher workload? Do patients also ask before making the pre-specified changes?

  • Do you consider that many patients would not be eligible for medication self-titration? What proportion of your patients would not be? Which patients would not be suitable candidates?

  • Do you feel comfortable with this method of pre-specified objectives for changing medication by the patient or would you always prefer to do it in a consultation?

  • In general terms, do you think your patients have followed the pre-specified medication change instructions?

  • Have you encountered conflicting situations? For example, has the patient asked why in situations with similar BP readings the doctor has not made treatment changes and now he has to make them? Do patients believe that it is only a way to reduce consultations?

  • Do patients forget initial training and repeatedly request consultations to ask about self-management?

Role of self-monitoring and self-adjustment of medication in health care
  • Can HBPM with self-titration be a method to reduce the workload of monitoring hypertensive patients? Is the workload for initial training excessive? (Excluding trial activities)

  • Does HBPM with self-titration offer greater opportunities for patient education and participation in the management of their disease (empowerment)? Is this useful?

  • In the ADAMPA trial, telemonitoring has not been used. Would you like to implement this type of self-control in an App? Should the App be connected to the electronic medical record or would this be a huge burden of unnecessary readings to evaluate?

  • What percentage of your patients do you think would adapt to using an App to improve their BP control? Do you think that an App that monitored patients’ BP (for example, a smart watch) would improve their control or generate unnecessary appointments and consultations?

  • Would you be in favour of introducing HBPM with self-titration as a routine element of hypertension management in primary care?

  • BP = blood pressure; HBPM = home blood pressure monitoring