Experiences and Challenges of Home Blood Pressure Monitoring Among Patients with Uncontrolled Hypertension: A Qualitative Study

Introduction Home blood pressure monitoring (HBPM) is recommended for hypertension management. However, patients’ experiences and challenges with HBPM, particularly among those with uncontrolled hypertension, remain poorly understood . This study aimed to explore how patients with uncontrolled hypertension experience and perform HBPM, and the challenges they encounter. Method Seventeen adults aged ≥21 years with uncontrolled hypertension were purposively recruited from three public primary care clinics in Singapore. A qualitative descriptive-interpretive study used in-depth, semi-structured, audio-recorded face-to-face interviews until data saturation. Interview transcripts were analysed thematically. The qualitative data were managed using NVivo version 14. Results Most participants owned an HBPM device, yet their practices varied widely. Patients engaged in selective monitoring, measuring blood pressure mainly when symptomatic or close to clinic visits. Many adapted HBPM routines to fit competing life demands, resulting in irregular timing and frequency. Selective recording of readings, including omission of higher values, was frequently reported. Documentation preferences differed by digital literacy, with older patients preferring paper records. HBPM was often perceived as a healthcare provider (HCP) assigned task rather than a self-care behaviour. Limited and inconsistent guidance from HCP contributed to confusion and reduced motivation. Conclusion Among patients with uncontrolled hypertension, guideline-concordant HBPM was shaped by practical barriers, uncertainty about correct monitoring and documentation, and the extent of HCP engagement. Participants’ selective monitoring and recording practices highlight the need for clearer patient education, consistent provider feedback, and tailored documentation approaches to support more reliable use of HBPM in primary care.