Key result
Among patients with uncontrolled hypertension, those most dissatisfied with their care reported significantly worse patient-centered care, lower self-confidence, more medication side effects, and higher treatment burden.
Why the study?
Hypertension control has been decreasing recently, prompting a comparison of experiences and attitudes toward care between patients with uncontrolled hypertension who are more versus less satisfied.
Cross-Sectional (n=1,697)
Yes
p-value: p=<0.01 to <0.001
Among patients with uncontrolled hypertension, dissatisfaction with care is common and driven by distinct, patient-specific factors such as medication side effects, treatment burden, and lack of patient-centered care.
Dissatisfaction with uncontrolled hypertension care links to varied patient issues; leaves open tailored interventions pending prospective trials.
Background: Hypertension control has been decreasing recently. We compared the experience and attitudes toward care between patients with uncontrolled hypertension who are more and less satisfied with that care to identify ways to improve their care. Methods: Baseline survey of 3072 patients with diagnosed hypertension and repeated blood pressure measurements at or above 150/95 mmHg during clinic appointments at 21 primary care clinics of a large Midwestern multi-specialty medical group. Survey questions were about previous hypertension care satisfaction, the degree to which that care was patient-centered, their feelings of self-confidence and treatment burden in managing hypertension, and medication side effects. Results: A total of 1697 patients completed surveys (response rate = 55%). Of the 1697 patients, the 24% who were most dissatisfied (scored 0 to 5 on a 0 to 10 scale of satisfaction) significantly differed from those most satisfied (scored 9 to 10) on all demographic and clinical characteristics as well as on every measure of care experience and health status. After adjusting for those characteristics, reports of patient-centered care, self-confidence, stopping the medication because of side effects, and the burdensomeness of treatment were all significantly worse (P <.01 to P <.001) than for those with a higher rating of their hypertension care. Correlations among these measures were low, so the people with each problem with care seem to be different. Conclusions: Many patients with uncontrolled hypertension are dissatisfied with their care, but that is associated with different problems for different people. Identifying and attending to these problems may provide opportunities to help them achieve better control.
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Solberg et al. (2021) conducted a cross-sectional in Uncontrolled hypertension (n=1,697). Dissatisfaction with hypertension care vs. High satisfaction with hypertension care was evaluated on Patient-reported experiences including patient-centered care, self-confidence, medication side effects, and treatment burden (p=<0.01 to <0.001). Among patients with uncontrolled hypertension, those most dissatisfied with their care reported significantly worse patient-centered care, lower self-confidence, more medication side effects, and higher treatment burden.
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