Developing and Piloting P3: A Patient-Centered Communication Curriculum for Hypertension Care - PROJECT SUMMARY/ABSTRACT Uncontrolled hypertension is a major public health concern. It is a significant risk factor for heart disease (the leading cause of death in the United States), and failing to control hypertension costs the U.S. billions each year. Increasing antihypertensive use is critical to reducing uncontrolled hypertension and preventing hypertension-related morbidity, mortality, and cost. Experimental studies suggest that enhancing patient- centered communication improves medication adherence and blood pressure control. The American Medical Association’s Measure Accurately, Act Rapidly, and Partner with Patients (MAP™) Hypertension program is a blood pressure quality improvement initiative. Its most promising component, Partner with Patients, comprises strategies that enhance patient-centeredness (e.g., patient-centered communication, conscientious prescribing) and strengthen patients’ self-efficacy to improve adherence. However, three key limitations exist: (1) the absence of communication-skills training; (2) the exclusion of strategies that address hypertensive patients’ specific communication concerns; and (3) the lack of tools to support patient-centered communication in time-limited visits. We hypothesize that expanding Partner with Patients to include (1) an innovative communication curriculum responsive to patient-identified challenges and (2) a tool that facilitates such communication will improve patient-clinician interactions, medication adherence, and hypertension control. Using Intervention Mapping, we will co-develop Partner with Patients Plus (P3), comprised of (1) a patient- centered communication skills training, (2) a communication guide, and (3) education on existing Partner with Patients materials. We will train family medicine residents at two sites using P3 and assess (a) changes in communication behaviors; (b) feasibility and acceptability; and (c) exploratory trends in patients’ hypertension control to inform future power analyses. Findings will provide preliminary data for a cluster-randomized pragmatic clinical trial to evaluate the impact on blood pressure outcomes among patients with uncontrolled hypertension. This K23 will provide Dr. Okah with essential training in patient-centered communication, communication analysis, behavioral interventions, pragmatic clinical trials, and qualitative and advanced mixed-methods approaches to inform intervention development, under the guidance of mentors with expertise in these areas. She will also receive didactic training in communication analysis, intervention design, clinical trials, and mixed-methods research. Upon completion, Dr. Okah will be well positioned to be an independent health services investigator who develops interventions to improve hypertension outcomes by enhancing patients’ care experiences and, in turn, treatment adherence.
