Exploration of a co-care service for chronic care management in patients with hypertension: A participatory qualitative study (Phase 1)

Introduction: In Switzerland, more than 80% of diagnosed individuals with hypertension are prescribed at least one blood pressure-lowering agent, yet 60% have uncontrolled blood pressure. To address this burden, co-care has been shown to improve systolic blood pressure control and to be cost-effective. Currently, no co-care service for hypertension management involving pharmacists, general practitioners (GPs), and patients is available in Switzerland. Aim: This qualitative study aimed to identify key elements supporting the future development of a co-care service for chronic hypertension management, informed by healthcare professionals' (HCPs) and patients' perspectives and experiences. Methods: This participatory study included semi-structured interviews with six pharmacists and six GPs, and a focus group of six patients with hypertension. Recruitment targeted diverse Swiss regions and practice settings to capture multiple perspectives and help shape the co-care service. Transcripts were coded using thematic analysis. Results: Pharmacists, GPs, and patients identified effective communication, mutual trust, and clear role differentiation as key elements to support the future development of a co-care service. Structured collaboration tools, such as shared hypertension guidelines, were viewed as necessary to support interprofessional collaboration. Improved information sharing, potentially through an electronic health record, was seen as key to care coordination, although concerns about data security remained. Contextual barriers, including political factors, highlighted the need for local implementation strategies. Conclusion: The key elements of a future co-care service for chronic hypertension management depend on mutual trust, a local and shared way of communication and collaboration among HCPs and patients, combined with a holistic patient-centered approach.