Key result
Physicians with higher rates of patient blood pressure control were more likely to use a patient-centered clinical approach, whereas less successful physicians were more paternalistic.
Observational
A patient-centered clinical approach, rather than a paternalistic one, is associated with greater success in achieving blood pressure control goals among physicians.
May support patient-centered hypertension care; qualitative data leave open need for prospective confirmation.
The authors recruited a group of physicians from among the investigators participating in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) with a greater (more successful) or lesser (less successful) proportion of trial patients meeting blood pressure (BP) control goals. The authors utilized qualitative focus group methods to identify similarities and differences in practice behaviors. Successful and less successful physicians had similarities in knowledge and practice behaviors regarding awareness of treatment guidelines, approaches to diagnosis, use of pharmacologic management, and the opinion that systolic BP guidelines should consider a patient's age. However, there were discernible differences between the two physician groups in their views on doctor-patient relationships: physicians from the less successful group were more paternalistic with their patients, while physicians from the more successful group were more likely to use a patient-centered clinical approach to BP awareness and management.
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Nwachuku et al. (2008) conducted an observational in High Blood Pressure. Physician practice behaviors was evaluated on Similarities and differences in practice behaviors. Physicians with higher rates of patient blood pressure control were more likely to use a patient-centered clinical approach, whereas less successful physicians were more paternalistic.
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