gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

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Antihypertensive Therapie - is a shared Decision Making Approach more effective?

Antihypertensive Therapie - ist Shared Decision Making effektiver?

Meeting Abstract (Hypertonie 2004)

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  • A. Deinzer - IPM - Institut für Präventive Medizin Universität Erlangen-Nürnberg
  • C. Kohnen - IMEREM - Insitute for Medical Research Management and Biometrics (Nürnberg, D)
  • R. Veelken - Department of Medicine IV, Universitätsklinikum (Erlangen-Nürnberg, D)
  • R.E. Schmieder - Department of Medicine IV, Universitätsklinikum (Erlangen-Nürnberg, D)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP92

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2004/04hoch092.shtml

Published: August 10, 2005

© 2005 Deinzer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: We tested the hypothesis that shared decision making (SDM) results in higher involvement of patients in blood pressure therapy.

Methods: The intervention group consisted of 15 physicians in primary care seeing 62 hypertensive patients (control group: 59 hypertensive patients). All 121 patients were enrolled in a patient education programme (J. Human Hypert. 2004). The 15 study physicians took part in a specially designed SDM-communication training. In the intervention group 6 SDM-consultations took place within two years. Changes of blood pressure were assessed in self- and physicians´ measurements. Questionnaires about the autonomy preference (API), the SDM process (COMRADE, IPM-score), quality of life (SF-36), health habits and life-style changes were analysed.

Results: In the intervention group a significant increase in SDM as judged by the patients could be assessed, but also in the control group there was some increase (changes from baseline: p<0.0001 and control p<0.01) pointing to a "carry-over effect".

After one year the fall in blood pressure within the intervention group was significant, in contrast to the control group (-9.9+10mm Hg /-3.5+11mm Hg, p=0.0005 /p<0.0001 and -5.91+12mm Hg/-3.0+8.77mm Hg, p=0.33/p=0.08). Of note, significantly more antihypertensive drugs were taken in the intervention group (p=0.013), but there were no significant life-style changes (sports, food, weight reduction) in both groups.

Conclusion: The concept of SDM could be implemented in daily practice of primary care physicians. As a consequence the adherence to drug treatment increased in the study group resulting in a significant blood pressure decrease after one year.