Helping Patients Manage Their Own Blood Pressures: A Strategy to Address Hypertension Control in the United States

Choudhry, Niteesh K.

doi:10.1161/circoutcomes.121.008220

Cited by 1 publication

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increasing interest in home-based hypertension strategies is underscored by inherent challenges in office-based hypertension management. 10 Some effective options include interventions combining home blood pressure monitoring with medication titration protocols, although these interventions have not been extensively studied in racially and ethnically diverse communities. 28 To enact these strategies, our study highlights some additional logistical challenges, including streamlining access to blood pressure cuffs, ensuring that PCPs and patients can obtain the most appropriate cuff for arm size, and value integration.…”

Section: Discussionmentioning

confidence: 99%

“…Second, blood pressure self-monitoring remains a source of confusion. Increasing interest in home-based hypertension strategies is underscored by inherent challenges in office-based hypertension management . Some effective options include interventions combining home blood pressure monitoring with medication titration protocols, although these interventions have not been extensively studied in racially and ethnically diverse communities .…”

Section: Discussionmentioning

confidence: 99%

“…2,9 Current care models for managing hypertension appear to be insufficient. 10 Given the increasing prevalence of hypertension, 11 the shortage of primary care providers (PCPs), 12 and the increasing interest in asynchronous care or care outside of offices (associated in part with the COVID-19 pandemic), 10 there is a need to design effective strategies to efficiently improve the quality of hypertension care. To our knowledge, few studies have explored perspectives on what would be specifically helpful to improve hypertension care, especially among racially and ethnically diverse populations in the US.…”

Section: Introductionmentioning

confidence: 99%

“…Current care models for managing hypertension appear to be insufficient . Given the increasing prevalence of hypertension, the shortage of primary care providers (PCPs), and the increasing interest in asynchronous care or care outside of offices (associated in part with the COVID-19 pandemic), there is a need to design effective strategies to efficiently improve the quality of hypertension care.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinicians’ and Patients’ Perspectives on Hypertension Care in a Racially and Ethnically Diverse Population in Primary Care

Lauffenburger

Barlev

Khatib³

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportanceHypertension control remains suboptimal, particularly for Black and Hispanic or Latino patients. A need exists to improve hypertension management and design effective strategies to efficiently improve the quality of care in primary care, especially for these at-risk populations. Few studies have specifically explored perspectives on blood pressure management by primary care providers (PCPs) and patients.ObjectiveTo examine clinician and patient perspectives on barriers and facilitators to hypertension control within a racially and ethnically diverse health care system.Design, Setting, and ParticipantsThis qualitative study was conducted in a large urban US health care system from October 1, 2020, to March 31, 2021, among patients with a diagnosis of hypertension from a racially and ethnically diverse population, for a range of hypertension medication use hypertension control, as well as practicing PCPs. Analysis was conducted between June 2021 and February 2022 using immersion-crystallization methods.Main Outcomes and MeasuresPerspectives on managing blood pressure, including medication adherence and lifestyle, considerations for intensification, and experiences and gaps in using health information technology tools for hypertension, were explored using semistructured qualitative interviews. These cycles of review were continued until all data were examined and meaningful patterns were identified.ResultsInterviews were conducted with 30 participants: 15 patients (mean [SD] age, 58.6 [16.2] years; 10 women [67%] and 9 Black patients [60%]) and 15 clinicians (14 PCPs and 1 medical assistant; 8 women [53%]). Eleven patients (73%) had suboptimally controlled blood pressure. Participants reported a wide range of experiences with hypertension care, even within the same clinics and health care system. Five themes relevant to managing hypertension for racially and ethnically diverse patient populations in primary care were identified: (1) difficulty with self-management activities, especially lifestyle modifications; (2) hesitancy intensifying medications by both clinicians and patients; (3) varying the timing and follow-up after changes in medication; (4) variation in blood pressure self-monitoring recommendations and uptake; and (5) limited specific functionality of current health information technology tools.Conclusions and RelevanceIn this qualitative study of the views of PCPs and patients on hypertension control, the participants felt that more focus should be placed on lifestyle modifications than medications for hypertension, particularly for patients from racial and ethnic minority groups. Participants also expressed concerns about the existing functionality of health information technology tools to support increasingly asynchronous hypertension care. More intentional ways of supporting treatment intensification, self-care, and follow-up care are needed to improve hypertension management for racially and ethnically diverse populations in primary care.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%