The journey to concordance for patients with hypertension: a qualitative study in primary care.
OBJECTIVE
We aimed to explore, using qualitative methods, the perspectives of patients with hypertension on issues relating to concordance in prescribing.


METHODS
This study took place in NHS general practices in Northern Ireland. A purposeful sample of patients who had been prescribed anti-hypertensive medication for at least one year were invited to participate in focus groups or semi-structured interviews; data were analysed using constant comparison.


METHODS
The perspectives of patients with hypertension on issues relating to concordance in prescribing.


RESULTS
Twenty-five individuals participated in five focus groups; two participated in semi-structured interviews. Participants felt they could make valuable contributions to consultations regarding their management. They were prepared to negotiate with GPs regarding their medication, but most deferred to their doctor's advice, perceiving doctors' attitudes and time constraints as barriers to their greater involvement in concordant decision-making. They had concerns about taking anti-hypertensive drugs, were aware of lifestyle influences on hypertension and reported using personal strategies to facilitate adherence and reduce the need to take medication.


CONCLUSIONS
Participants indicated a willingness to be involved in concordance in prescribing anti- hypertensive medication but needed health professionals to address their concerns and confusion about the nature of hypertension. These findings suggest that there is a need for doctors and other healthcare professionals with responsibility for prescribing to develop skills specifically to explore the beliefs and views underlying an individual's medication use. Such skills may need to be developed through specific training programmes at both undergraduate and postgraduate level.
Bane
Catherine
C
Research and Development Office, 12-22 Linenhall Street, Belfast, BT2 8BS, Northern Ireland, UK.
Hughes
Carmel M
CM
Cupples
Margaret E
ME
McElnay
James C
JC
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland / Q000453:epidemiology; D010349:Patient Compliance / Q000523:psychology; D010361:Patients / Q000523:psychology*; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011369:Professional-Patient Relations
D000959:Antihypertensive Agents