First Level Code: CCM Domain | Second Level Code: Intervention (e-BP) Components | Emergent Themes: Barriers and Facilitators to Implementation | Third Level Code: CFIR Domain | |
Self-management support | Patient BP self-monitoring and training | Cost concerns (B) | Outer setting | |
Accuracy concerns (B) | ||||
Lack of IT competence (B) | ||||
Improves quality of care (F) | Intervention characteristics | |||
Empowers patients (F) | ||||
Interpretation concerns (B) | Characteristics of individuals | |||
Design of delivery system | Web-based pharmacist care | Questions about pharmacy selection (B) | Outer setting | |
Lack of trust (B) | ||||
Lack of financial incentive (B) | ||||
Lack of time (B) | ||||
Concerns about team roles and relationships (B) | Intervention characteristics | |||
Empowers patients (F) | ||||
Patient convenience (F) | ||||
Saves staff time (F) | ||||
Additional support for patients (F) | ||||
Long-term cost savings (F) | ||||
Collaborative care benefits (F) | ||||
High-quality care (F) | ||||
Concerns about collaborative practice (B) | Characteristics of individuals | |||
Design of delivery system, clinical information systems, self-management support | Use of E-mail or websites to support communication about BP | Lack of financial incentive (B) | Outer setting | |
Lack of IT access (B) | ||||
Lack of IT competence (B) | ||||
IT access (F) | ||||
IT competence (F) | ||||
IT readily available (F) | Inner setting | |||
Confidentiality concerns (B) | Intervention characteristics | |||
Increases workload (B) | ||||
Convenience (F) | ||||
Increases efficiency (F) | ||||
Improves quality of care (F) | ||||
Increases workload (B) | Characteristics of individuals | |||
Patient convenience (F) | ||||
Empowers patients (F) | ||||
Neutral effect on workload (F) | ||||
Reduces patient costs (F) | ||||
Decision support | JNC-based protocols | Liability protection (F) | Outer setting | |
Standardizes care (F) | ||||
Convenience (F) | ||||
Low self-efficacy (B) | ||||
Concern about protocol (B) | ||||
High self-efficacy (F) | ||||
Clinical information systems | Identifies patients with uncontrolled BP | IT issues (B) | Inner setting |
↵* Sustainability was an overarching theme.
B, barrier; BP, blood pressure; CCM, Chronic Care Model; CFIR, Consolidated Framework for Implementation Research; e-BP, Electronic Communications and Home Blood Pressure Monitoring; F, facilitator; IT, information technology; JNC, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP.