Preventing Chronic Disease | Patient and Practice Perspectives on Strategies for Controlling Blood Pressure, North Carolina, 2010–2012 - CDC
Patient and Practice Perspectives on Strategies for Controlling Blood Pressure, North Carolina, 2010–2012
Katrina E. Donahue, MD, MPH; Maihan B. Vu, DrPH, MPH; Jacqueline R. Halladay, MD, MPH; Cassandra Miller, MPH; Beverly A. Garcia, MPH; Doyle M. Cummings, PharmD; Crystal W. Cene, MD, MPH; Alan Hinderliter, MD; Edwin Little, MD; Marjorie Rachide, FNP; Darren DeWalt, MD, MPH
Suggested citation for this article: Donahue KE, Vu MB, Halladay JR, Miller C, Garcia BA, Cummings DM, et al. Patient and Practice Perspectives on Strategies for Controlling Blood Pressure, North Carolina, 2010–2012. Prev Chronic Dis 2014;11:130157. DOI: http://dx.doi.org/10.5888/pcd11.130157
PEER REVIEWED
Abstract
Introduction
Patient and practice perspectives can inform development of team-based approaches to improving blood pressure control in primary care. We used a community-based participatory research approach to assess patient and practice perceptions regarding the value of team-based strategies for controlling blood pressure in a rural North Carolina population from 2010 through 2012.
Patient and practice perspectives can inform development of team-based approaches to improving blood pressure control in primary care. We used a community-based participatory research approach to assess patient and practice perceptions regarding the value of team-based strategies for controlling blood pressure in a rural North Carolina population from 2010 through 2012.
Methods
In-depth interviews were conducted with 41 adults with hypertension, purposely sampled to include diversity of sex, race, literacy, and blood pressure control, and with key office staff at 5 rural primary care practices in the southeastern US “stroke belt.” Interviews explored barriers to controlling blood pressure, the practice’s role in controlling blood pressure, and opinions on the use of team care delivery.
In-depth interviews were conducted with 41 adults with hypertension, purposely sampled to include diversity of sex, race, literacy, and blood pressure control, and with key office staff at 5 rural primary care practices in the southeastern US “stroke belt.” Interviews explored barriers to controlling blood pressure, the practice’s role in controlling blood pressure, and opinions on the use of team care delivery.
Results
Patients reported that provider strategies to optimize blood pressure control should include regular visits, medication adjustment, side-effect discussion, and behavioral counseling. When discussing team-based approaches to hypertension care, patients valued verbal encouragement, calls from the doctor’s office, and the opportunity to ask questions. However, they voiced concerns about the effect of having too many people involved in their care. Practice staff focused on multiple, broad methods to control blood pressure including counseling, regular office visits, media to improve awareness, and support groups. An explicit focus of delivering care as teams was a newer concept.
Patients reported that provider strategies to optimize blood pressure control should include regular visits, medication adjustment, side-effect discussion, and behavioral counseling. When discussing team-based approaches to hypertension care, patients valued verbal encouragement, calls from the doctor’s office, and the opportunity to ask questions. However, they voiced concerns about the effect of having too many people involved in their care. Practice staff focused on multiple, broad methods to control blood pressure including counseling, regular office visits, media to improve awareness, and support groups. An explicit focus of delivering care as teams was a newer concept.
Conclusion
When developing a team approach to hypertension treatment, patients value high-quality communication and not losing their primary relationship with their provider. Practice staff members were open to a team-based approach but had limited knowledge of what such an approach would entail.
When developing a team approach to hypertension treatment, patients value high-quality communication and not losing their primary relationship with their provider. Practice staff members were open to a team-based approach but had limited knowledge of what such an approach would entail.
Author Information
Corresponding Author: Katrina E Donahue, MD, MPH, University of North Carolina at Chapel Hill, Department of Family Medicine, 590 Manning Dr, Chapel Hill, NC 27599. Telephone: 919-966-5090. Email: kdonahue@med.unc.edu.
Author Affiliations: Maihan B. Vu, Jacqueline R. Halladay Cassandra Miller, Beverly A. Garcia, Crystal W. Cene, Alan Hinderliter, Darren DeWalt, University of North Carolina, Chapel Hill, North Carolina; Doyle M. Cummings, East Carolina University, Greenville, North Carolina; Edwin Little, Marjorie Rachide, primary care practices in eastern North Carolina.
References
MEDSCAPE CME
Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC andPreventing Chronic Disease. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at www.medscape.org/journal/pcd; (4) view/print certificate.
; (4) view/print certificate.Release date: April 24, 2014; Expiration date: April 24, 2015
Learning Objectives
Upon completion of this activity, participants will be able to:
- Distinguish significant variables identified by patients as barriers to better blood pressure control
- Distinguish significant variables identified by healthcare professionals as barriers to better blood pressure control
- Analyze what patients believe that healthcare professionals can do to help them improve their blood pressure control
- Evaluate attitudes of patients and healthcare professionals toward team-based care for hypertension
EDITORS
Rosemarie Perrin, Technical Writer/Editor, Preventing Chronic Disease. Disclosure: Rosemarie Perrin has disclosed no relevant financial relationships.
CME AUTHOR
Charles P. Vega, MD, Associate Professor and Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.
Charles P. Vega, MD, Associate Professor and Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.
AUTHORS AND CREDENTIALS
Disclosures: Katrina E. Donahue, MD, MPH; Maihan B. Vu, DrPH, MPH; Jacqueline R. Halladay, MD, MPH; Cassandra Miller, MPH; Beverly A. Garcia, MPH; Doyle M. Cummings, PharmD; Crystal W. Cene, MD, MPH; Alan Hinderliter, MD; Edwin Little, MD; and Marjorie Rachide, FNP have disclosed no relevant financial relationships.
Darren DeWalt, MD, MPH, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: Merck.
Affiliations: Katrina E. Donahue, Maihan B. Vu, Jacqueline R. Halladay Cassandra Miller, Beverly A. Garcia, Crystal W. Cene, Alan Hinderliter, Darren DeWalt, University of North Carolina, Chapel Hill, North Carolina; Doyle M. Cummings, East Carolina University, Greenville, North Carolina; Edwin Little, Marjorie Rachide, primary care practices in eastern North Carolina.
Disclosures: Katrina E. Donahue, MD, MPH; Maihan B. Vu, DrPH, MPH; Jacqueline R. Halladay, MD, MPH; Cassandra Miller, MPH; Beverly A. Garcia, MPH; Doyle M. Cummings, PharmD; Crystal W. Cene, MD, MPH; Alan Hinderliter, MD; Edwin Little, MD; and Marjorie Rachide, FNP have disclosed no relevant financial relationships.
Darren DeWalt, MD, MPH, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: Merck.
Affiliations: Katrina E. Donahue, Maihan B. Vu, Jacqueline R. Halladay Cassandra Miller, Beverly A. Garcia, Crystal W. Cene, Alan Hinderliter, Darren DeWalt, University of North Carolina, Chapel Hill, North Carolina; Doyle M. Cummings, East Carolina University, Greenville, North Carolina; Edwin Little, Marjorie Rachide, primary care practices in eastern North Carolina.
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