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Related Experiment Videos

Shared decision-making in antihypertensive therapy: a cluster randomised controlled trial.

Iris Tinsel1, Anika Buchholz, Werner Vach

  • 1Department of Medicine, Division of General Practice, University Medical Centre Freiburg, Elsässerstr 2m, Freiburg 79110, Germany. iris.tinsel@uniklinik-freiburg.de.

BMC Family Practice
|September 13, 2013
PubMed
Summary

Shared decision making (SDM) training for general practitioners did not improve patient participation or lower blood pressure in hypertensive patients. Further research is needed to explore patient involvement in hypertension management.

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Area of Science:

  • Cardiology
  • General Practice
  • Health Services Research

Background:

  • Hypertension is a major risk factor for cardiovascular diseases, with many patients not achieving target blood pressure.
  • Shared decision making (SDM) aims to increase patient engagement in their healthcare.
  • Limited data exists on the impact of SDM training for general practitioners (GPs) in antihypertensive therapy.

Purpose of the Study:

  • To evaluate the effect of an SDM training program for GPs on patient participation and blood pressure control.
  • To test if SDM training enhances patient participation and reduces blood pressure (BP) compared to usual care.

Main Methods:

  • A cluster randomised controlled trial (cRCT) involving GP practices in Southwest Germany.
  • Patients with treated but uncontrolled hypertension and/or relevant comorbidity were included.
  • Primary endpoints included changes in patient-perceived participation (SDM-Q-9) and systolic blood pressure (24h-mean).

Main Results:

  • The study included 1120 patients from 36 GP practices.
  • No significant or clinically relevant effect of SDM training was observed on patient participation or blood pressure.
  • Secondary endpoints, including diastolic BP, patient knowledge, adherence, and cardiovascular risk, also showed no significant improvement.

Conclusions:

  • The hypothesis that SDM training improves patient participation and lowers BP in hypertension management was not confirmed.
  • Further investigation is required to understand the role of patient participation in primary care hypertension treatment.