From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study

IntroductionAs stroke incidence rises with an aging population, hypertension remains a critical modifiable risk factor for both primary and secondary stroke prevention. Effective management of hypertension post-stroke requires a shift from fragmented care to integrated, patient-centered approaches....

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Main Authors: Hala F. Azhari, Jonathan Hewitt, Martin O'Neill, Alexander Smith, Terence Quinn, Jesse Dawson
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Stroke
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Online Access:https://www.frontiersin.org/articles/10.3389/fstro.2025.1453087/full
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author Hala F. Azhari
Jonathan Hewitt
Martin O'Neill
Alexander Smith
Terence Quinn
Jesse Dawson
author_facet Hala F. Azhari
Jonathan Hewitt
Martin O'Neill
Alexander Smith
Terence Quinn
Jesse Dawson
author_sort Hala F. Azhari
collection DOAJ
description IntroductionAs stroke incidence rises with an aging population, hypertension remains a critical modifiable risk factor for both primary and secondary stroke prevention. Effective management of hypertension post-stroke requires a shift from fragmented care to integrated, patient-centered approaches. This study explores the perspectives of stroke survivors and healthcare professionals on hypertension management and evaluates the acceptability of innovative strategies, including 24-h ambulatory blood pressure monitoring (ABPM).MethodsA qualitative study using grounded theory methodology was conducted through focus group interviews with stroke survivors and healthcare professionals in Wales and Scotland between January 2019 and December 2022. Participants included 48 individuals representing diverse backgrounds and experiences. Data were analyzed thematically to identify barriers and facilitators in hypertension management post-stroke.ResultsKey findings identified four major themes: the need for improved cooperation among multidisciplinary teams, knowledge gaps in stroke survivors regarding hypertension's role in stroke risk, the complexities of polypharmacy, and the potential benefits of ABPM for individualized care. Stroke survivors expressed a reliance on clinicians for hypertension management, while healthcare professionals emphasized the importance of empowering patients through education and self-management. ABPM emerged as a promising tool to enhance hypertension monitoring and support patient engagement, though practical challenges remain.DiscussionThe study underscores the importance of integrating patient education, multidisciplinary care, and advanced monitoring techniques like ABPM into hypertension management. Strengthening communication pathways between patients and healthcare providers can foster greater patient engagement and accountability. Addressing socio-economic barriers, improving patient-clinician communication, and implementing holistic care strategies are critical for reducing recurrent stroke risk. These findings emphasize the need for systemic reforms and targeted interventions to bridge gaps in hypertension care delivery post-stroke.
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spelling doaj-art-abeb6d534a0f4ebc889bede055ba33822025-01-30T06:22:10ZengFrontiers Media S.A.Frontiers in Stroke2813-30562025-01-01410.3389/fstro.2025.14530871453087From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative studyHala F. Azhari0Jonathan Hewitt1Martin O'Neill2Alexander Smith3Terence Quinn4Jesse Dawson5College of Medicine and Pharmacy, Umm Al-Qura University, Mecca, Saudi ArabiaSchool of Geriatric Medicine, Cardiff University, Newport, United KingdomSocial and Economic Research Data and Methods, Cardiff University, Newport, United KingdomClinical Research and Innovation Centre, St. Woolos Hospital, Newport, United KingdomSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United KingdomSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United KingdomIntroductionAs stroke incidence rises with an aging population, hypertension remains a critical modifiable risk factor for both primary and secondary stroke prevention. Effective management of hypertension post-stroke requires a shift from fragmented care to integrated, patient-centered approaches. This study explores the perspectives of stroke survivors and healthcare professionals on hypertension management and evaluates the acceptability of innovative strategies, including 24-h ambulatory blood pressure monitoring (ABPM).MethodsA qualitative study using grounded theory methodology was conducted through focus group interviews with stroke survivors and healthcare professionals in Wales and Scotland between January 2019 and December 2022. Participants included 48 individuals representing diverse backgrounds and experiences. Data were analyzed thematically to identify barriers and facilitators in hypertension management post-stroke.ResultsKey findings identified four major themes: the need for improved cooperation among multidisciplinary teams, knowledge gaps in stroke survivors regarding hypertension's role in stroke risk, the complexities of polypharmacy, and the potential benefits of ABPM for individualized care. Stroke survivors expressed a reliance on clinicians for hypertension management, while healthcare professionals emphasized the importance of empowering patients through education and self-management. ABPM emerged as a promising tool to enhance hypertension monitoring and support patient engagement, though practical challenges remain.DiscussionThe study underscores the importance of integrating patient education, multidisciplinary care, and advanced monitoring techniques like ABPM into hypertension management. Strengthening communication pathways between patients and healthcare providers can foster greater patient engagement and accountability. Addressing socio-economic barriers, improving patient-clinician communication, and implementing holistic care strategies are critical for reducing recurrent stroke risk. These findings emphasize the need for systemic reforms and targeted interventions to bridge gaps in hypertension care delivery post-stroke.https://www.frontiersin.org/articles/10.3389/fstro.2025.1453087/fullstrokehypertensionhealthcare professionalsstroke survivorspublic healthfocus groups qualitative study
spellingShingle Hala F. Azhari
Jonathan Hewitt
Martin O'Neill
Alexander Smith
Terence Quinn
Jesse Dawson
From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study
Frontiers in Stroke
stroke
hypertension
healthcare professionals
stroke survivors
public health
focus groups qualitative study
title From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study
title_full From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study
title_fullStr From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study
title_full_unstemmed From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study
title_short From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study
title_sort from fragmented to integrated healthcare managing hypertension post stroke a qualitative study
topic stroke
hypertension
healthcare professionals
stroke survivors
public health
focus groups qualitative study
url https://www.frontiersin.org/articles/10.3389/fstro.2025.1453087/full
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