Title

Stakeholder Perspectives on the Evolution of Hypertension Care Under the Patient Centered Medical Home

Document Type

Presentation

Publication Date

4-2-2015

Comments

Advisor:

R Brawer, Jefferson Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.

Abstract

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease. Yet, the proportion of adults whose hypertension is controlled remains low. The Patient Centered Medical Home (PCMH) model has been shown to improve blood pressure control. This study explored stakeholder perspectives on hypertension care in the context of the PCMH. In all, 118 semi-structured interviews were conducted at 17 primary care practices in Southeastern Pennsylvania participating in a PCMH transformation initiative. Interviews were conducted with clinicians (n=47), medical assistants (n=26), office administrators (n=12), care managers (n=11), front office staff (n=7), patient educators (n=4), nurses (n=4), social workers (n=4), and other stakeholders (n=3). Grounded theory methodology was used to identify themes related to hypertension care. Participants emphasized the challenges of hypertension care, including the prevalence of hypertension, perceptions of hypertension control versus actual performance, and intensity of services needed in hypertension care. In addition, participants discussed the following themes related to achieving the PCMH attributes as a part of hypertension care: 1) patient-centered care; 2) a team approach to care; 3) a systems-based approach to quality; and 4) coordinated care across the health system. While improving hypertension care in the context of the PCMH presented new challenges for the practices, interview participants expressed excitement about improving hypertension care as a part of PCMH transformation. Practices undergoing PCMH transformation should consider these perspectives as they work to optimize hypertension care and improve clinical outcomes.

Presentation: 15 minutes