Hypertension and Its Impact on Healthcare

Hypertension, a condition affecting approximately 108 million adults in the United States, poses significant challenges in disease management despite its prevalence (CDC, 2020). By 2025, it is estimated that over 1.5 billion people worldwide will be living with hypertension (Li et al., 2015). In the U.S., only one in four adults diagnosed with hypertension has their condition under control (CDC, 2020). Hypertension not only affects the quality of care provided but also compromises patient safety and increases healthcare costs.

Quality of Care

Globally, hypertension accounts for 13% of deaths, and inadequate detection, awareness, treatment, and control are major risk factors contributing to uncontrolled hypertension (Khatib et al., 2014). Barriers to quality care can be categorized into patient-related, healthcare provider-related, and healthcare system-related issues. These barriers affect the behavior of healthcare providers and patients, ultimately influencing hypertension management.

Using a behavior change theoretical framework, Khatib et al. explored barriers to hypertension control, categorizing them into capability barriers, intention barriers, and healthcare system barriers (Khatib et al., 2014). Capability barriers include knowledge and skill gaps, while intention barriers relate to motivation and social influence. Healthcare system barriers involve resource availability, affordability, and the acceptability of services.

Providers often face challenges in keeping up with new clinical information, educating patients, and addressing prehypertension in at-risk individuals. Intention barriers, such as lack of motivation and reluctance to change clinical practices, also hinder quality care. Additionally, healthcare system barriers, including limited consultation time and insufficient financial reimbursement, are common obstacles reported by providers (Khatib et al., 2014).

From the patient’s perspective, capability barriers vary, with some patients aware of hypertension risk factors while others lack this knowledge. Many patients also struggle with understanding blood pressure readings and the consequences of hypertension, highlighting the need for better education (Khatib et al., 2014). Intention barriers, such as lack of motivation to adhere to treatment plans, and healthcare system barriers, such as limited access to resources, further complicate hypertension management for patients.

Improving the Quality of Care

To enhance the quality of care for hypertensive patients, healthcare providers must adopt patient-centered care approaches and utilize frameworks like the middle-range theory of nursing in hypertension care. This theory emphasizes the importance of behavior modification, assessing patient readiness for lifestyle changes, and establishing clear outcomes. Effective communication, shared decision-making, and promoting self-care are critical components of this approach (Drevenhorn, 2018).

Patient Safety

Barriers to patient safety, such as ineffective communication, lack of multidisciplinary collaboration, and inadequate patient education, can severely impact hypertensive patients. Ineffective communication can lead to medication errors, delayed treatment, and nonadherence to treatment plans, increasing the risk of complications (Yunk, 2019). Collaboration among healthcare providers is essential to prevent medical errors and ensure high-quality care (Rosen et al., 2018).

Improving Patient Safety

Engaging patients and their caregivers in their care is vital to improving patient safety. Utilizing effective communication and adopting a patient-centered care model can enhance adherence to treatment plans and reduce the risk of complications (Jolles, Clark, & Braam, 2012). This approach has been shown to improve quality care and lower healthcare costs by involving patients in their care decisions (White-Trevino & Dearmon, 2018).

Cost Considerations

Hypertension significantly increases healthcare costs, with hypertensive patients incurring approximately $2,000 more annually than those without the condition (Kirkland et al., 2018). The U.S. population with hypertension faces an estimated $131 billion in additional healthcare costs each year. The American Heart Association recommends early intervention, maintaining healthy blood pressure levels, multidisciplinary collaboration, and addressing social and economic barriers to reduce these costs (Vise, 2019).

The Effect of Policies

The Affordable Care Act (ACA) has played a crucial role in improving access to healthcare and reducing costs, particularly for vulnerable populations. By expanding Medicaid and eliminating coverage denials for preexisting conditions, the ACA has improved hypertension management for many patients (Sommers, 2014). Increased access to healthcare has led to better diagnosis, treatment adherence, and overall health outcomes for hypertensive patients.

Assessing the Problem: A Case Study

To further assess the problem, I interviewed B.N., a 61-year-old male diagnosed with hypertension one year ago. B.N. expressed challenges in understanding hypertension, managing lifestyle changes, and dealing with financial stressors due to job loss and limited resources in his rural community. Using the middle-range theory of nursing, I assessed B.N.’s readiness for lifestyle modifications and discussed strategies to improve his disease management.

B.N. acknowledged that he had struggled with managing his condition and expressed a strong desire to make changes to live long enough to see his grandchildren grow up. Our discussion revealed several barriers, including lack of education, financial stress, ineffective communication, and limited access to resources. B.N. believed that a team-based approach would provide the support and guidelines needed for successful disease management.

Conclusion

In conclusion, patient-centered care, multidisciplinary collaboration, and expanding the role of nurses are essential strategies for improving the quality of care provided to hypertensive patients. Adopting a patient-centered care model that meets individual patient needs can enhance disease management and treatment adherence, ultimately leading to better health outcomes.

References

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