{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:49:12Z","timestamp":1774522152614,"version":"3.50.1"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["U18 HS26849-01"],"award-info":[{"award-number":["U18 HS26849-01"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Center for Advancing Translational Sciences (NCATS), National Institutes of Health","award":["UL1TR002369"],"award-info":[{"award-number":["UL1TR002369"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Hypertension, persistent high blood pressures (HBP) leading to chronic physiologic changes, is a common condition that is a major predictor of heart attacks, strokes, and other conditions. Despite strong evidence, care teams and patients are inconsistently adherent to HBP guideline recommendations. Patient-facing clinical decision support (CDS) could help improve recommendation adherence but must also be acceptable to clinicians and patients.<\/jats:p><jats:p>\n          Objective\u2003This study aimed to partly address the challenge of developing a patient-facing CDS application, we sought to understand provider variations and rationales related to HBP guideline recommendations and perceptions regarding patient role and use of digital tools.<\/jats:p><jats:p>\n          Methods\u2003We engaged hypertension experts and primary care respondents to iteratively develop and implement a pilot survey and a final survey which presented five clinical cases that queried clinicians' attitudes related to actions; variations; prioritization; patient input; importance; and barriers for HBP diagnosis, monitoring, and treatment. Analysis of Likert's scale scores was descriptive with content analysis for free-text answers.<\/jats:p><jats:p>\n          Results\u2003Fifteen hypertension experts and 14 providers took the pilot and final version of the surveys, respectively. The majority (&gt;80%) of providers felt the recommendations were important, yet found them difficult to follow-up to 90% of the time. Perceptions of relative amounts of patient input and patient work for effective HBP management ranged from 22 to 100%. Stated reasons for variation included adverse effects of treatment, patient comorbidities, shared decision-making, and health care cost and access issues. Providers were generally positive toward patient use of electronic CDS applications but worried about access to health care, nuance of recommendations, and patient understanding of the tools.<\/jats:p><jats:p>\n          Conclusion\u2003At baseline, provider management of HBP is heterogeneous. Providers were accepting of patient-facing CDS but reported preferences for that CDS to capture the complexity and nuance of guideline recommendations.<\/jats:p>","DOI":"10.1055\/a-1926-0199","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T23:29:52Z","timestamp":1660778992000},"page":"1131-1140","source":"Crossref","is-referenced-by-count":6,"title":["Provider Perspectives on Patient- and Provider-Facing High Blood Pressure Clinical Decision Support"],"prefix":"10.1055","volume":"13","author":[{"given":"David A.","family":"Dorr","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua E.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Center for Health Informatics and Evidence Synthesis, RTI International, Chicago, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Bobo","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"D'Autremont","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Rope","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"Dunne","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven Z.","family":"Kassakian","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States"},{"name":"Department of Medicine, Oregon Health and Science University, Portland, Oregon, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lipika","family":"Samal","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"issue":"289","key":"ref1","first-page":"1","article-title":"Hypertension prevalence and control among adults: United States, 2015-2016","author":"C D Fryar","year":"2017","journal-title":"NCHS Data Brief"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"430","DOI":"10.7326\/M16-1785","article-title":"Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians","volume":"166","author":"A Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"issue":"22","key":"ref3","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1511939","article-title":"A randomized trial of intensive versus standard blood-pressure 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