Clinicians' and patients' perspectives on hypertension care in a racially and ethnically diverse population in primary care

• Published in: JAMA Network Open
• Main Authors: Lauffenburger, Julie C, Barlev, Renee A, Khatib, Rasha, Glowacki, Nicole, Siddiqi, Alvia, Everett, Marlon E, Albert, Michelle A, Keller, Punam A, Samal, Lipika, Hanken, Kaitlin, Sears, Ellen S, Haff, Nancy, Choudhry, Niteesh K
• Format: Text
• Language: unknown
• Published: Advocate Aurora Health Institutional Repository 2023
• Subjects: hypertension; racial diversity; ethnic diversity; primary care; Advocate Aurora Research Institute; Population Health and Public Health; Cardiology; Aurora Research Institute
• Online Access: https://institutionalrepository.aah.org/allother/460; https://doi.org/10.1001/jamanetworkopen.2023.0977; https://libkey.io/libraries/1712/10.1001/jamanetworkopen.2023.0977

Importance: Hypertension 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. Objective: To examine clinician and patient perspectives on barriers and facilitators to hypertension control within a racially and ethnically diverse health care system. Design, setting, and participants: This 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 measures: Perspectives 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. Results: Interviews 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 ...