Patient-provider engagement
The patients and HCPs reflected on the engagement between each other relating to the relationship built and support provided during the intervention.Patients reported a sense of security, as they knew that they were being monitored closely by the healthcare team, who would alert them of any irregular or missing BP readings. F035 (male, 67 years old) even exclaimed “I feel happy!” when he received an unscheduled teleconsultation for a rise in BP. This also motivated him to measure BP regularly and look out for triggers. HCPs concurred that issues with patients’ BP could be addressed in a timelier manner through this intervention as the healthcare team could intervene quickly, if needed, through a teleconsultation or phone medication titration. HCPs felt that their relationship with patients improved, as the ready technical support rendered by the care coordinators, frequent phone calls and encouragement by the doctors and care managers, and BP improvements contributed to the building of rapport and between patient and HCPs.Conversely, four patients were expecting to receive feedback on their BP readings from the healthcare team during the trial, but they did not seem to have received any phone calls. Two were aged 47–49 years old and two were aged 64–73 years old. This affected their confidence in the patient-provider engagement, as F007 wondered “if someone is looking at my records or just for the sake of collecting data”. They preferred more regular interaction with the healthcare team to understand HCP workflows in relation to monitoring BP readings, provide feedback on the process and receive advice on their BP readings and lifestyle management.F029 (male, 49 years old) recounted that she had to return to the clinic to refill her medications as the doctor increased the dosage over phone medication titration. However, the pharmacy was not informed and she “had to wait for quite some time because I guess they need to clarify with the doctor… So if that link is there, it’s more convenient.” This also highlighted that the healthcare teams need to work with other clinic staff who might not be part of but still support the core team, such as the pharmacist.