Document Type
Article
Publication Date
2-2016
Abstract
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 patientcentered 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 semistructured 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.
Recommended Citation
O’Donnell AJ, Bogner HR, Cronholm PF, Kellom K, Miller-Day M, McClintock HF, et al. Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home. Prev Chronic Dis 2016;13:150383. DOI: http://dx.doi.org/10.5888/pcd13.150383
Copyright
The United States Government has placed this work in the public domain to be used and reproduced by anyone without permission.
Comments
This article was originally published in Preventing Chronic Disease, volume 13, in 2016. DOI: 10.5888/pcd13.150383