Hussain Tanvir, Allen Allyssa, Halbert Jennifer, Anderson Cheryl A M, Boonyasai Romsai Tony, Cooper Lisa A
Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument St. Room 2-604C, Baltimore, MD, 21287, USA,
J Gen Intern Med. 2015 Apr;30(4):454-61. doi: 10.1007/s11606-014-3130-4. Epub 2014 Dec 17.
Care management has become a widespread strategy for improving chronic illness care. However, primary care provider (PCP) participation in programs has been poor. Because the success of care management relies on provider engagement, understanding provider perspectives is necessary.
Our goal was to identify care management functions most valuable to PCPs in hypertension treatment.
Six focus groups were conducted to discuss current challenges in hypertension care and identify specific functions of care management that would improve care.
The study included 39 PCPs (participation rate: 83 %) representing six clinics, two of which care for large African American populations and four that are in underserved locations, in the greater Baltimore metropolitan area.
This was a qualitative analysis of focus groups, using grounded theory and iterative coding.
Providers desired achieving blood pressure control more rapidly. Collaborating with care managers who obtain ongoing patient data would allow treatment plans to be tailored to the changing life conditions of patients. The P.A.R.T.N.E.R. framework summarizes the care management functions that providers reported were necessary for effective collaboration: Partner with patients, providers, and the community; Arrange follow-up care; Resolve barriers to adherence; Track treatment response and progress; Navigate the health care system with patients; Educate patients & Engage patients in self-management; Relay information between patients and/or provider(s).
The P.A.R.T.N.E.R. framework is the first to offer a checklist of care management functions that may promote successful collaboration with PCPs. Future research should examine the validity of this framework in various settings and for diverse patient populations affected by chronic diseases.
护理管理已成为改善慢性病护理的广泛策略。然而，初级保健提供者（PCP）参与项目的情况不佳。由于护理管理的成功依赖于提供者的参与，因此了解提供者的观点很有必要。
我们的目标是确定在高血压治疗中对初级保健提供者最有价值的护理管理功能。
进行了六个焦点小组讨论，以探讨高血压护理当前面临的挑战，并确定可改善护理的护理管理具体功能。
该研究包括来自大巴尔的摩都会区六家诊所的39名初级保健提供者（参与率：83%），其中两家诊所主要服务大量非裔美国人，四家位于服务不足地区。
这是一项对焦点小组的定性分析，采用扎根理论和迭代编码。
提供者希望更快实现血压控制。与获取患者持续数据的护理经理合作，将使治疗计划能够根据患者不断变化的生活状况进行调整。P.A.R.T.N.E.R.框架总结了提供者报告的有效协作所需的护理管理功能：与患者、提供者和社区合作；安排后续护理；解决依从性障碍；跟踪治疗反应和进展；与患者一起应对医疗系统；教育患者并让患者参与自我管理；在患者和/或提供者之间传递信息。
P.A.R.T.N.E.R.框架是首个提供护理管理功能清单的框架，这些功能可能促进与初级保健提供者的成功协作。未来的研究应检验该框架在各种环境中以及对受慢性病影响的不同患者群体的有效性。
