Patients’ Attitudes and Approaches to the Self-Management of Hypertension: Perspectives from an Australian Qualitative Study in Community Pharmacy

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Journal Article
High Blood Pressure and Cardiovascular Prevention, 2017, 24 (2), pp. 149 - 155
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© 2017, Springer International Publishing Switzerland. Introduction: In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients’ motivation to practice self-care. Aim: To gauge patients’ approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. Method: This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients’ perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. Results: Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as ‘normal’. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. Conclusion: This study highlights patients’ inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients’ self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.
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