Key result
Patient-centered primary care linked to ~196% higher odds of BP control versus standard care.
Why the study?
It was unknown whether implementing a patient-centered approach in healthcare delivery can improve adherence to guidelines and quality of care in hypertensive patients.
Does a patient-centered approach improve blood pressure control and guideline adherence in hypertensive patients?
Cohort (n=200)
No
Does a patient-centered approach improve blood pressure control and guideline adherence in hypertensive patients?
Integrating a patient-centered approach in primary care for hypertension improves adherence to clinical guidelines and significantly increases the likelihood of achieving blood pressure control.
Answers are grounded in this paper and cite their sources.
May support patient-centered hypertension care in primary practice; leaves open confirmation via randomized trials before changing guidelines.
BACKGROUND: Treating hypertensive patients by integrating the patient-centered approach would influence the practice and outcome of treatment. Our purpose was to determine whether the implementation of a patient-centered approach in health care delivery can improve adhering to guidelines and the quality-of-care. METHODS: A retrospective study was conducted using secondary data from the electronic medical records of the patients treated in the two primary care outpatient settings at the Family Medicine (FM) and Social Security (SS) clinics. A key feature of the FM clinic is the incorporation of a patient-centered approach in its service delivery. Individual information regarding initial assessment and treatment at the follow-up visits was reviewed for 1 year. Comparison of adherence to treatment guidelines between the two primary care clinics was performed by using chi-square, Fisher's exact test or a t-test. To explore the difference in blood pressure and BP control between the two clinics, linear and logistic regression analysis respectively were performed with an adjustment for CV risk score in 2016 as a key confounder. RESULTS: The evidence included 100 records from each clinic, showed variation between the two primary care sites. The FM clinic had more complete records regarding family history of hypertension, assessment for secondary causes, prescription for lifestyle modification and appropriate adjustment of medication. Higher levels of blood pressure control were recorded in the FM clinic, specifically systolic pressure 2.92 mmHg (p = 0.073) and diastolic pressure 5.38 mmHg (p < 0.001) lower than those recorded in the SS clinic. There was a 2.96 times higher chance for BP goals to be achieved in patients in receipt of hypertensive care at the FM clinic (p = 0.004). CONCLUSIONS: Adopting a patient-centered approach in service delivery could improve the quality of care for hypertension patients in primary care in Thailand.
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Buawangpong et al. (2020) conducted a cohort in Hypertension (n=200). Patient-centered medicine approach (Family Medicine clinic) vs. Standard general practice care (Social Security clinic) was evaluated on Achievement of blood pressure control goals (OR 2.96, 95% CI 1.41-6.22, p=0.004). A patient-centered medicine approach in primary care increased the odds of achieving blood pressure control goals by nearly 3 times (OR 2.96) compared to standard general practice care.
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