Management of high blood pressure in clinical practice: perceptible qualitative differences in approaches utilized by clinicians.
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.
Nwachuku
Chuke E
CE
National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
Bastien
Arnaud
A
Cutler
Jeffrey A
JA
Grob
Glenda M
GM
Margolis
Karen L
KL
Roccella
Edward J
EJ
Pressel
Sara
S
Davis
Barry R
BR
Caso
Michael
M
Sheps
Sheldon
S
Weber
Michael
M
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001794:Blood Pressure; D003657:Decision Making; D020000:Decision Support Systems, Clinical; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research
D000959:Antihypertensive Agents