Beata Bajorek1, Kate Lemay2, Parker Magin3, Christopher Roberts4, Ines Krass5, Carol Armour2,6. 1. Graduate School of Health-Pharmacy, CB01.13.31, The University of Technology Sydney, Broadway, NSW, 2007, Australia. beata.bajorek@uts.edu.au. 2. Woolcock Institute of Medical Research, University of Sydney, 431 Glebe Point Road, Glebe, NSW, 2037, Australia. 3. Discipline of General Practice, University of Newcastle, Newbolds Building, University Drive, Callaghan, NSW, 2308, Australia. 4. Sydney Medical School-Northern, Hornsby Ku-ring-Gai Hospital, Palmerston Road, Hornsby, NSW, 2077, Australia. 5. Faculty of Pharmacy, University of Sydney, Building A15 Science Road, Camperdown, NSW, 2006, Australia. 6. Sydney Local Health District, Glebe, Australia.
Abstract
INTRODUCTION: In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. AIM: To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. METHOD: This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. RESULTS: Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as 'normal'. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. CONCLUSION: This study highlights patients' inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients' self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.
INTRODUCTION: In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. AIM: To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. METHOD: This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. RESULTS: Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as 'normal'. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. CONCLUSION: This study highlights patients' inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients' self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.
Authors: E D Janus; S J Bunker; A Kilkkinen; K Mc Namara; B Philpot; P Tideman; R Tirimacco; T K Laatikainen; S Heistaro; J A Dunbar Journal: Intern Med J Date: 2008-02-14 Impact factor: 2.048
Authors: Ronald G Victor; David Leonard; Paul Hess; Deepa G Bhat; Jennifer Jones; Patrice A C Vaeth; Joseph Ravenell; Anne Freeman; Ruth P Wilson; Robert W Haley Journal: Arch Intern Med Date: 2008-06-23
Authors: Beata V Bajorek; Kate S Lemay; Parker J Magin; Christopher Roberts; Ines Krass; Carol L Armour Journal: BMC Med Educ Date: 2015-09-28 Impact factor: 2.463