Patients' and general practitioners' views of what constitutes appropriate hypertension management.
OBJECTIVE
To explore how patients and general practitioners (GPs) construct the concept of appropriateness in the context of hypertension management.


METHODS
Q-methodology was used. The study involved 120 patients and 12 GPs ranking 42 statements according to their degree of agreement or disagreement when considering appropriate hypertension management. The statements, comprising both clinical and non-clinical attributes, were developed from a qualitative study. Factor analysis of the data, using PQMethod computer software, determined if any patterns were discernible.


RESULTS
Patients (n = 92) and GPs (n = 10) exclusively clustered to six factors (factor loadings > or = 0.5, P <0.01), which accounted for 77% of the total variance. The findings indicated that patients and GPs consider appropriate hypertension management in different ways. The GPs indicated that they considered non-pharmacological measures highly important, whereas 72% of patients were ambivalent. The patients clustered to five appropriateness factors, which varied in the degree of involvement patients had, or wished to have, in their hypertension management. Of these five, two were chosen by 73 patients.


CONCLUSIONS
GPs' views differ from those of patients and there is variation between patients, which has important implications for patient-centred care. Further application of Q-methodology to explore patients' views of appropriateness of other medical conditions would be valuable.
Morecroft
Charles
C
School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK. charles.morecroft@man.ac.uk
Cantrill
Judy
J
Tully
Mary
M
D000328:Adult; D000368:Aged; D004739:England; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010821:Physicians, Family / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires