Is patient participation in hypertension care based on patients' preferences? A cross-sectional study in primary healthcare

Aims The purpose of this study was to address the need to improve opportunities for patient participation in their health and health services. This paper reports if and how patients' preferences matched their experiences of participation in treatment for hypertension in primary healthcare and what factors were linked with having had opportunities for participation that matched one's preferences.Methods and results A total of 949 adult patients treated for hypertension completed the Patient Preferences for Patient Participation (4Ps) tool, with which they ranked their preferences for and experiences of patient participation. Descriptive and comparative analyses of 4Ps data were performed to identify patient characteristics associated with preference-based participation. Approximately half of the participants experienced patient participation to the extent that they preferred. Women were more likely to have had less patient participation than their preference compared with men. Women were also more likely to prefer being more engaged in hypertension care than men. There were also marked associations between age and educational level with the extent of participation preferred and experienced, leaving patients younger than or with lower education than the mean in this study with more insufficient opportunities for patient participation.Conclusion There is a lack of concurrence between patients' preferences for, and experiences of, patient participation, especially for women. Further efforts to facilitate person-centred engagement are required, along with research on what strategies can overcome human and organizational barriers.Registration ClinicalTrials.gov: NCT03554382 Graphical Abstract