TY - JOUR
T1 - Patient-Facing Clinical Decision Support for High Blood Pressure Control
T2 - Patient Survey
AU - Dorr, David
AU - D'Autremont, Chris
AU - Richardson, Joshua E.
AU - Bobo, Michelle
AU - Terndrup, Christopher
AU - Dunne, M. J.
AU - Cheng, Anthony
AU - Rope, Robert
N1 - Publisher Copyright:
©David Dorr, Chris D'Autremont, Joshua E Richardson, Michelle Bobo, Christopher Terndrup, M J Dunne, Anthony Cheng, Robert Rope.
PY - 2023
Y1 - 2023
N2 - Background: High blood pressure (HBP) affects nearly half of adults in the United States and is a major factor in heart attacks, strokes, kidney disease, and other morbidities. To reduce risk, guidelines for HBP contain more than 70 recommendations, including many related to patient behaviors, such as home monitoring and lifestyle changes. Thus, the patient’s role in controlling HBP is crucial. Patient-facing clinical decision support (CDS) tools may help patients adhere to evidence-based care, but customization is required. Objective: Our objective was to understand how to adapt CDS to best engage patients in controlling HBP. Methods: We conducted a mixed methods study with two phases: (1) survey-guided interviews with a limited cohort and (2) a nationwide web-based survey. Participation in each phase was limited to adults aged between 18 and 85 years who had been diagnosed with hypertension. The survey included general questions that assessed goal setting, treatment priorities, medication load, comorbid conditions, satisfaction with blood pressure (BP) management, and attitudes toward CDS, and also a series of questions regarding A/B preferences using paired information displays to assess perceived trustworthiness of potential CDS user interface options. Results: We conducted 17 survey-guided interviews to gather patient needs from CDS, then analyzed results and created a second survey of 519 adults with clinically diagnosed HBP. A large majority of participants reported that BP control was a high priority (83%), had monitored BP at home (82%), and felt comfortable using technology (88%). Survey respondents found displays with more detailed recommendations more trustworthy (56%-77% of them preferred simpler displays), especially when incorporating social trust and priorities from providers and patients like them, but had no differences in action taken. Conclusions: Respondents to the survey felt that CDS capabilities could help them with HBP control. The more detailed design options for BP display and recommendations messaging were considered the most trustworthy yet did not differentiate perceived actions.
AB - Background: High blood pressure (HBP) affects nearly half of adults in the United States and is a major factor in heart attacks, strokes, kidney disease, and other morbidities. To reduce risk, guidelines for HBP contain more than 70 recommendations, including many related to patient behaviors, such as home monitoring and lifestyle changes. Thus, the patient’s role in controlling HBP is crucial. Patient-facing clinical decision support (CDS) tools may help patients adhere to evidence-based care, but customization is required. Objective: Our objective was to understand how to adapt CDS to best engage patients in controlling HBP. Methods: We conducted a mixed methods study with two phases: (1) survey-guided interviews with a limited cohort and (2) a nationwide web-based survey. Participation in each phase was limited to adults aged between 18 and 85 years who had been diagnosed with hypertension. The survey included general questions that assessed goal setting, treatment priorities, medication load, comorbid conditions, satisfaction with blood pressure (BP) management, and attitudes toward CDS, and also a series of questions regarding A/B preferences using paired information displays to assess perceived trustworthiness of potential CDS user interface options. Results: We conducted 17 survey-guided interviews to gather patient needs from CDS, then analyzed results and created a second survey of 519 adults with clinically diagnosed HBP. A large majority of participants reported that BP control was a high priority (83%), had monitored BP at home (82%), and felt comfortable using technology (88%). Survey respondents found displays with more detailed recommendations more trustworthy (56%-77% of them preferred simpler displays), especially when incorporating social trust and priorities from providers and patients like them, but had no differences in action taken. Conclusions: Respondents to the survey felt that CDS capabilities could help them with HBP control. The more detailed design options for BP display and recommendations messaging were considered the most trustworthy yet did not differentiate perceived actions.
KW - blood pressure control
KW - clinical decision support
KW - decision-making support
KW - high blood pressure
KW - hypertension
KW - patient engagement
KW - patient support tool
KW - shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85149989337&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85149989337&partnerID=8YFLogxK
U2 - 10.2196/39490
DO - 10.2196/39490
M3 - Article
AN - SCOPUS:85149989337
SN - 2561-1011
VL - 7
JO - JMIR Cardio
JF - JMIR Cardio
M1 - e39490
ER -