A Qualitative Study of Patient Perspectives about Hypertension

Abstract

To understand hypertensive patients' perspectives regarding blood pressure and hypertension treatment, this qualitative study applied semistructured interviews of hypertensive patients. Participants were recruited from two hypertension clinics at the University of Alberta in Edmonton, Canada. To be eligible for inclusion, patients had to be aged 18 years or older, diagnosed with hypertension by a healthcare provider, and currently taking an antihypertensive medication. Participants were stratified in the analysis according to blood pressure control. Twenty-six patients (mean age 57; 62% female) were interviewed, of which 42% were on target and 58% were not. Three underlying themes emerged from the interviews: (a) knowledge of blood pressure relating to diagnosis and management and control of hypertension, (b) integration of hypertension management into daily routine, and (c) feelings and beliefs of wellness. None of the above themes were associated with better control. Knowledge gaps were found, which emphasize the need for further patient education and physician training. Feelings and beliefs of wellness, and not knowledge, were important factors in home assessment of blood pressure. The absence of connections between control of hypertension and the identified domains indicates that current approaches could benefit from the development of a more personalized approach for education and communication.

Barriers and facilitators to treatment among patients with newly diagnosed hypertension in Nepal

“…However, implementation of these recommendations is often prone to failure due to various barriers, such as lack of awareness, poor adherence to medication, low motivation for lifestyle changes and lack of family support. A qualitative study on patient perspective of hypertension done in Canada found that patients struggled to define hypertension; only half of them (54%) could recall their targeted blood pressure threshold 12. Other qualitative studies conducted in Malaysia13 and the USA14 reported that their patients were not aware that hypertension could be asymptomatic, and the asymptomatic patients considered themselves healthy.…”

Patient perspectives on factors associated with enrollment and retention in chronic disease self-management programs: a systematic review

“…47 However, patients reported that enrollment and participation in chronic disease self-management behaviors was complicated by their dependence on family members, 44,50,51 especially those who required informal care and assistance. 45,47,54 Although patients reported that social and emotional support from family and friends was important in facilitating their self-management behaviors, 51 participants also reported poor family support as precluding self-management. 37,44 Some patients believed that asking for assistance with self-management would become a burden on their family and friends.…”

“…Patients also reported unfavorable attitudes toward enrolling and participating in guided self-management programs due to already high preexisting knowledge of how to best self-manage their own chronic condition. 37,54 However, in two studies, patients living with COPD and hypertension reported several positive attitudes toward participating in self-management programs, including the opportunity to learn more about their condition. 50,52 Patients living with various chronic diseases, including cardiovascular disease, chronic lower respiratory conditions, and type 2 diabetes, reported not enrolling, because self-management programs would not teach them anything new and different from what they already learned from their general practitioner.…”

“…Patients reported that they would not participate or would eventually drop out of a program if it interfered with personal issues such as employment, hobbies, social life, and family vacations. 37,[49][50][51]54 Need factors…”

“…47,54 Two other studies indicated that patients without debilitating symptoms who did not require immediate medical attention were less likely to participate in self-management behaviors and programs.…”