Perspectives of patients and physicians regarding hypertensive management from an online survey for excellence: a subanalysis of the PARADOX study by physician categories

Abstract

An existing clinical problem in Japan is the high prevalence of uncontrolled hypertension despite the availability of various effective therapies. Here, we analyzed survey data to gain insight into this paradox from physicians' perspectives, with results categorized according to specialty (i.e., with or without certification by the Japanese Society of Hypertension [JSH]), institution type, gender, and age. A web-based survey of typical educational activities for patients regarding hypertension management was conducted in Japan between October 19 and 31, 2017. Differences between physician groups were investigated per category. Survey results from 541 physicians were analyzed: 59 JSH certified (i.e., 'specialist') vs 482 non-JSH certified (i.e., 'nonspecialist') physicians; 192 general practitioners vs 349 hospital physicians; 500 males vs 41 females; and 178 younger (mean age: 40.7 years), 174 middle-aged (52.0 years) or 189 older (61.3 years) physicians. The most statistically significant differences between groups were observed in the category of physician specialty. Compared with nonspecialists, specialist physicians were more conscious of providing education on patient lifestyle modifications, more aware of patient-and physician-derived issues, and understood and followed the treatment guidelines. General practitioners cared more about the patient's burden than did hospital physicians. Younger physicians identified the need to incorporate the patient's perspective into their treatment. This analysis shows that the provision and perceptions of education differ between physician categories. Compared with specialist physicians, nonspecialists were less likely to provide adequate guidance on lifestyle modifications, possibly due to their uncertainty in understanding treatment guideline recommendations. Further education of nonspecialists on hypertension management may be warranted.

Physician and patient perspectives on hypertension management and factors associated with lifestyle modifications in Japan: results from an online survey

“…Finally, the present study does not account for the different categories attributed to the physicians. A subanalysis of the PARADOX study investigating the physicians' perspective by specialty, institution type, sex, and age has been published [36].…”

Digital health technology and hypertension management: a qualitative analysis of patient and specialist provider preferences on data tracking

“…Our findings that patients and hypertension specialists perceive a limited relevance in questionnaires on general health status and patient satisfaction in hypertension clinical practice are novel as most PROMs evaluated in hypertension patients focus on mental health measures of depression [26] . These findings may be explained by a lack of awareness and understanding of the potential utility of standardized assessments by patients and providers, provider and patient preferences for only minimal data collection that is directly relevant to clinical decision making for hypertension [9] and overly lengthy or insufficiently patient-centered, standardized assessments specific to hypertension [27] . Currently, the Hyper-PRO originally developed in China is the only hypertension-specific PROM to our knowledge, and this has not been validated across multiple populations for usability or acceptability [18] .…”

“…These digital tools often rely on long-term patient tracking of home BP and other data parameters. While studies examined patient understanding and perspectives of home BP monitoring, there are limited data on the perspectives of patients on tracking other health data for hypertension self-management, including the use of patient-reported outcome measures (PROMs) [9] . Further, there are few studies examining the perspectives and understanding of health data tracking by hypertension specialists who provide care for patients with complex and severe hypertension [10] .…”

Seven‐action approaches for the management of hypertension in Asia – The HOPE Asia network

“…The results showed significant reductions in both 24-hour ambulatory BP and morning home SBP in patients managed using the HERB system. 99 Compared with specialist physicians, non-specialists are less likely to provide adequate guidance on lifestyle modifications, 113 possibly due to their uncertainty in understanding treatment guideline recommendations. In addition, there are significant gaps between physician and patient perspectives on hypertension management.…”