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Provider Perspectives on Patient- and Provider-Facing High Blood Pressure Clinical Decision Support
David A Dorr1, Joshua E Richardson2, Michelle Bobo1
1Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States.
Applied Clinical Informatics
|August 17, 2022
Summary
Provider management of high blood pressure (HBP) varies, despite guideline adherence challenges. Patient-facing decision support tools are accepted but must capture complex recommendations for effective HBP care.
Area of Science:
- Cardiology
- Health Informatics
- Clinical Practice Guidelines
Background:
- Persistent high blood pressure (HBP) is a major predictor of cardiovascular events.
- Inconsistent adherence to HBP guidelines by care teams and patients presents a significant challenge.
- Patient-facing clinical decision support (CDS) may improve adherence but requires clinician and patient acceptance.
Purpose of the Study:
- To understand provider variations and rationales concerning HBP guideline recommendations.
- To assess provider perceptions of the patient's role in HBP management.
- To explore provider views on the utility of digital tools for HBP care.
Main Methods:
- Iterative development and implementation of pilot and final surveys involving hypertension experts and primary care providers.
- Utilized five clinical cases to query clinician attitudes on HBP diagnosis, monitoring, and treatment.
- Descriptive analysis of Likert scale scores and content analysis of free-text responses.
Main Results:
- Most providers (>80%) deemed HBP guidelines important but found adherence difficult (up to 90% of the time).
- Perceptions of patient input and work in HBP management varied widely (22-100%).
- Providers expressed concerns about patient access, recommendation complexity, and understanding of digital tools.
Conclusions:
- Provider management of HBP is currently heterogeneous.
- Clinicians are receptive to patient-facing CDS but desire tools that reflect the complexity of HBP guidelines.
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