Sociodemographic and Clinical Characteristics and Self-Care Behaviors Are Associated With Shared Decision-Making in Adults With Hypertension

Abstract

BACKGROUND: Shared decision-making (SDM) is a collaborative process between clinicians and patients. While SDM is known to enhance blood pressure control in adults with hypertension, the impact of sociodemographic and clinical characteristics on SDM remains unclear. METHODS: We conducted a cross-sectional study of adults with hypertension at an academic health care system. Participants were recruited from electronic health records and completed an anonymous survey assessing SDM with CollaboRATE. We used multivariable linear regression to assess sociodemographic and clinical impacts on SDM. RESULTS: Among 4181 participants, 62.5% were White adults, 64% had at least a bachelor’s degree, 53.9% had an annual household income?>$75 000, and half of the participants had a diagnosis of hypertension for?>10 years. The mean SDM score was 6.73 (±2.5) ranging from 0 to 9. Adults aged ≥65 years (β=−0.234; SE, 0.117; P=0.046) and women (β=−0.416; SE, 0.096; P<0.001) reported lower SDM scores. Black adults (β=0.384; SE, 0.109; P=0.001) and those with a prior telemedicine appointment (β=0.493; SE, 0.098; P<0.001) reported higher SDM scores. Postgraduate education, longer duration of hypertension diagnosis, and poor self-care were negatively associated with SDM scores (β=−0.503, −0.472, and −0.745; P=0.014, 0.033, and <0.001, respectively). CONCLUSIONS: Age, race, sex, telemedicine history, education level, diagnosis duration, and self-care behaviors all significantly impacted SDM scores in patients with hypertension. These results suggest that further research to inform tailored interventions targeting these factors could enhance SDM and hypertension management.