Perception of hypertension management by patients and doctors in Asia: potential to improve blood pressure control.
BACKGROUND
Hypertension is one of the world's most common health conditions and is a leading risk factor for mortality. Although blood pressure can be modified, there is a large proportion of patients whose blood pressure remains uncontrolled. The aim of this study, termed Edvantage 360°, was to gain a deeper understanding of hypertension management in Asia from the perspective of patients and doctors, and to propose strategies to improve blood pressure control.


METHODS
Conducted in Hong Kong, Indonesia, Malaysia, the Philippines, South Korea, Taiwan, and Thailand, Edvantage 360° was a mixed-methods observational study that used both qualitative and quantitative elements: qualitative interviews and focus groups with patients (N = 110), quantitative interviews with patients (N = 709), and qualitative interviews with doctors (N = 85).


RESULTS
This study found that, although there is good understanding of the causes and consequences of hypertension among Asian patients, there is a lack of urgency to control blood pressure. Doctors and patients have different expectations of each other and a divergent view on what constitutes successful hypertension management. We also identified a fundamental gap between the beliefs of doctors and patients as to who should be most responsible for the patients' hypertension management. In addition, because patients find it difficult to comply with lifestyle modifications (often because of a decreased understanding of the changes required), adherence to medication regimens may be less of a limiting factor than doctors believe.


CONCLUSIONS
Doctors may provide better care by aligning with their patients on a common understanding of successful hypertension management. Doctors may also find it helpful to provide a more personalized explanation of any needed lifestyle modifications. The willingness of the doctor to adjust their patient interaction style to form a 'doctor-patient team' is important. In addition, we recommend that doctors should not attribute ineffectiveness of the treatment plan to patient non-adherence to medications, but rather adjust the medication regimen as needed.
An Nur Specialist Hospital, No. 19 Medan Pusat Bandar 1 Section 9, 436550 Bandar Baru Bangi, Kajang Malaysia.
Abdul Rashid Abdul
AR
Rahman
Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Ji-Guang
JG
Wang
Pro-Cardio Heart Disease & Stroke Prevention Centre, Tsim Sha Tsui, Hong Kong.
Gary Mak Yiu
GM
Kwong
Department of Internal Medicine and Cardiology, Manila Doctors Hospital, Manila, Philippines.
Dante D
DD
Morales
Praram 9 Hospital, Bangkok, Thailand.
Piyamitr
P
Sritara
Department of Cardiology and Vascular Medicine, University of Indonesia, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
Renan
R
Sukmawan
Attitude to health; Hong Kong; Hypertension; Indonesia; Malaysia; Philippines; Qualitative research; South Korea; Taiwan; Thailand