Hans van den Heuvel

DISCUSSION This study analyzed user experiences with a blended care approach for the monitoring of HDP (SAFE@HOME study). Overall, the results of the questionnaires and interviews corresponded and were supplementary. The effects of using mHealth met the expectations of the participants, who were overall very satisfied with the easy-to-use technology. mHealth was considered to support patient autonomy by providing information and ways to be in control, but the interpretation of the measurements requires the involvement of health care professionals. Participants also noted a few possibilities for improvement. With the focus on future development and implementation of mHealth in care, we extracted multiple recommendations from our results: 1. Be modest in the communication regarding expected group benefits of the digital health technology to prevent disappointing individual patients who do not experience these specific benefits. 2. Provide the user insight into the data; in particular, a graphic representation over time is a helpful method to foster patient knowledge and can support patients to participate in clinical decision making. 3. The mHealth data should be integrated in (electronic) health records and should be accessible to all health care professionals that are engaged in care. 4. The health care professionals should remain responsible for the interpretation of data obtained via digital monitoring, as the clinical expertise of health care professionals is necessary for the early detection of abnormalities and clinical decision making. 5. Health care professionals should be aware of (pregnant) patients’ willingness and capability to self-measure their blood pressure at home. 6. Symptom score lists and blood pressure thresholds should be personalized, meaning that the questions should be adapted to the pregnancy term and thresholds should be set to fit the user’s situation. 7. The moment and frequency of measurement should be communicated clearly but should also be sensitive and adaptable to the daily life of the user. Our Findings in Context Currently, several digital technologies are being developed that moderate or replace traditional clinical care. The study described here is an excellent example of such digital health technology in the clinical context that replaces some of the care traditionally provided in the clinical setting with digital monitoring at home. Our study confirmed several findings described by other digital monitoring studies. Some comparable studies have reported on remote blood pressure monitoring in pregnancy, without in-clinic monitoring by care professionals. 21,22 For a comparable intervention with clinical monitoring, only survey data CHAPTER 7 114