{"id":"db68b936f104","type":"article","url":"https://hartvaat.nl/2026/05/19/team-gebaseerde-telehealth-bloeddrukbehandeling-acceptabel-en-haalbaar-in-achter/","title":"Team-gebaseerde telehealth-bloeddrukbehandeling acceptabel en haalbaar in achterstandsklinieken — mixed-methods evaluatie","title_en":"","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Journal of the American Heart Association","doi":"10.1161/JAHA.125.047236","source_url":"https://doi.org/10.1161/JAHA.125.047236","authors":["Sunit Chhetri","Srista Manandhar","Austin L Seals","Justin Kramer","Yashashwi Pokharel"],"significance":5,"published":"2026-06-14","source_date":"2026-05-19","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/","https://hartvaat.nl/kennis/hypertensie/resistente-hypertensie/"],"congress":"","summary_en":"Implementation evaluation of a team-based telehealth blood pressure management program using home BP monitoring, self-management, and social support in underserved patient populations. Mixed-methods approach with 20 patients and 16 clinic staff from 2 safety-net clinics in North Carolina, framed by EPIS and Health Equity Implementation Frameworks. Five themes emerged: (1) staffing barriers and coordinated teamwork with user-friendly tools, (2) patient- and provider-centred approach, (3) ease of home BP monitoring, (4) personalised self-management calls, (5) social support. Both patients and clinic staff rated the program highly on acceptability (4.42/5), appropriateness (4.42/5), and feasibility (4.40/5). Successful implementation depends on tailoring, trust-building, and financial sustainability.","created":"2026-07-03T10:33:03Z","updated":"2026-07-03T13:31:57Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Implementatie-evaluatie van een team-gebaseerd telehealth-programma voor bloeddrukbehandeling met thuisbloeddruk-monitoring, zelfmanagement en sociale ondersteuning bij ondervertegenwoordigde patiëntenpopulaties. Mixed-methods aanpak met 20 patiënten en 16 zorgverleners uit 2 safety-net-klinieken in North Carolina, op basis van EPIS- en Health Equity Implementation Frameworks. Vijf thema's: (1) personeelsbarrières en gecoördineerde teamzorg met gebruiksvriendelijke tools, (2) patiënt- én zorgverlener-centrale benadering, (3) gemak van thuisbloeddruk-monitoring, (4) gepersonaliseerde zelfmanagement-gesprekken, (5) sociale ondersteuning. Programma werd door zowel patiënten als zorgverleners hoog gescoord op aanvaardbaarheid (4,42/5), geschiktheid (4,42/5) en haalbaarheid (4,40/5). Implementatie hangt af van maatwerk, vertrouwen en financiële houdbaarheid.","abstract_original":"BACKGROUND: Hypertension management using home blood pressure monitoring-guided pharmacotherapy is more effective than clinic-based care, but the benefit is attenuated in underserved patients. We evaluated implementation determinants of a team-based telehealth hypertension management program providing home blood pressure monitoring-guided pharmacotherapy and self-management and social support. METHODS: We used Exploration, Preparation, Implementation and Sustainment, and Health Equity Implementation Frameworks for semistructured interviews and inductive/deductive coding using thematic analysis of qualitative data and quantitative analysis to evaluate team-based telehealth hypertension management program implementation facilitators, barriers, acceptability, appropriateness, and feasibility. We purposefully sampled 20 patients with hypertension and 16 clinic key players from 2 safety-net clinics in North Carolina. Quantitative measures were Acceptability of Intervention Measure, Intervention Appropriateness Measure, Feasibility of Intervention Measure, Patient Assessment of Chronic Illness Care, Organizational Readiness for Implementing Change (all measures' score ranged 1-5; higher score is better). We used concurrent embedded mixed methods (qualitative + quantitative) for convergence and complementarity. RESULTS: Five qualitative themes emerged around (1) staffing barriers, coordinated teamwork, and friendly study tools; (2) the program's patient and provider centeredness; (3) ease of home blood pressure monitoring; (4) personalized, comprehensive self-management calls; and (5) social support. Patients and clinic key players found the program acceptable (mean±SD, 4.42±0.84 and 4.56±0.59), appropriate (4.42±0.86 and 4.61±0.50), and feasible (4.40±0.89 and 4.44±0.53), respectively. Patient Assessment of Chronic Illness Care and Organizational Readiness for Implementing Change scores were 4.22±1.01 and 4.11±0.78, respectively. CONCLUSIONS: Implementing a team-based telehealth hypertension management program depends on its tailoring to patients and providers and having their endorsement; a user-friendly and trust-promoting model; and having a viable financial plan. Future studies should assess clinical and cost effectiveness of the program. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05424744."}