Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  O’Donnell, Alison J. ; Bogner, Hillary R. ; Kellom, Katherine ; Miller-Day, Michelle ; McClintock, Heather F. de Vries ; Kaye, Elise M. ; Gabbay, Robert ; Cronholm, Peter F.
• Description:
  Introduction ; Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. ; Methods ; The PCMH transformation initiative conducted 118 semi structured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. 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 administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. ; Results ; Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. ; Conclusion ; Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.
• Subjects:
  • Attitude of Health Personnel
  • Humans
  • Hypertension
  • Interviews as Topic
  • Models, Organizational
  • Patient-Centered Care
  • Primary Health Care
  • Self Care
• Source:
  Prev Chronic Dis. 13.
• DOI:
  http://dx.doi.org/10.5888/pcd13.150383
• ISSN:
  1545-1151
• Pubmed ID:
  26916899
• Pubmed Central ID:
  PMC4768875
• Document Type:
  Journal Article
• Funding:
  R18 HS019150/HS/AHRQ HHS/United States ; R21 MH094940/MH/NIMH NIH HHS/United States ; R34 MH085880/MH/NIMH NIH HHS/United States ; 5R18HS019150/HS/AHRQ HHS/United States
• Place as Subject:
  Pennsylvania
• Location:
  North America
• Volume:
  13
• Download URL:
  https://stacks.cdc.gov/view/cdc/38303/cdc_38303_DS1.pdf
• File Type:
  [PDF - 293.91 KB]
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:900c33c6f9790f20502cb38d90cc2630bd897f1ac30a59776a8cdd6343d06d81545f6c6abc43d730f943db898de794acecfda43cc908abf391514a7829031d76