Acceptance, use and challenges of digital prevention for arterial hypertension – a qualitative study among patients with high blood pressure in Germany

BACKGROUND: Arterial hypertension is one of the leading causes of premature death worldwide. In the care of patients with hypertension, digital tools - such as apps or wearables - can potentially help in prevention to facilitate lifestyle changes or to improve blood pressure control. In hypertension care in Germany, digital applications are only sporadically used by patients and recommended by physicians. This study, therefore, investigates the following questions: What preventive measures do hypertension patients use to manage their condition? What barriers can be identified? How is the use and acceptance of digital technologies for behavioural prevention? METHODS: We conducted semi-structured interviews with 31 patients with arterial hypertension in Germany. The interviews were conducted either in person or by phone and were analysed using Qualitative Content Analysis. RESULTS: Some interviewees use digital tools for prevention regularly, while others never do. Others have used them in the past or occasionally. Several facilitators and barriers to health behaviours and the use of digital tools were identified. These include the interviewees' comorbidities, their routines, habits and preferences, as well as their attitude towards technological innovations. Their work situation, their financial resources and the support - or lack thereof - they receive from physicians and from their social environment also play a role. Furthermore, there are differences in the attribution of responsibility among the interviewees. While some attribute responsibility for health to the individual, others emphasise the relevance of aggravating and supportive conditions. CONCLUSIONS: The findings indicate which factors influence the use of digital prevention tools by patients with hypertension. As described in the context of the digital divide and the inequality paradox of prevention, socioeconomic factors play a significant role in both health behaviour and the use of digital prevention tools. Some patients with hypertension may benefit from the use of digital prevention tools if appropriate conditions are created. During implementation, care should be taken to avoid exacerbating existing inequalities. TRIAL REGISTRATION: DRKS00029761 (registration date july 27th 2022).