Facilitators and Barriers to Standardized Community Hypertension Management in Chinese Older Adults From Service Providers and Recipients: A Qualitative Study

OBJECTIVE: To explore the facilitators and barriers to standardized hypertension management in community health centers (CHCs) as perceived by service providers (community doctors and nurses) and recipients (elderly patients with hypertension and their caregivers). METHODS: This qualitative study consisted of two parts: Study 1 involved service providers, while Study 2 involved service recipients. Both studies utilized interview guides based on the tailored implementation for chronic disease (TICD) framework. Data were collected in Changsha, China, from July to September 2022, and analyzed using Directed Content Analysis. RESULTS: Study 1 involved 16 participants, and Study 2 included 37 participants. Both service providers and recipients identified facilitators and barriers to standardized community hypertension management for older adults across seven domains of the TICD framework and three levels (initiators, service providers, and service recipients, along with their interconnections). The prominent facilitators and barriers were perceived differently by service providers and recipients, who also noted both common and differing influencing factors. CONCLUSION: These facilitators and barriers underscore the complex and multidimensional nature of hypertension management. The findings can assist primary healthcare institutions in optimizing nursing practices. Through the collaborative efforts of initiators, service providers, and recipients, the effective implementation of standardized hypertension management can be enhanced.