Care Partner Perspectives on Hypertension Management in Alzheimer Disease and Related Dementias in an Online Forum: Qualitative Thematic Analysis.

摘要

BACKGROUND: Family care partners manage care for individuals with Alzheimer disease and related dementias (ADRD), including hypertension management crucial for preventing cognitive decline. Nurses frequently interact with these caregiver-patient dyads but have limited evidence about caregivers' real-world experiences of managing this comorbidity. Understanding these experiences is essential for developing nurse-led interventions that support both patients and caregivers. OBJECTIVE: This study aimed to explore ADRD care partners' perceptions, experiences, and challenges related to hypertension management. A qualitative thematic analysis of care partner posts from an online forum focused on ADRD was conducted. METHODS: We analyzed 300 posts from ALZConnected, collected using the keywords "hypertension" and "blood pressure." Two independent researchers used reflexive thematic analysis, following the Braun and Clarke framework until data saturation was achieved. RESULTS: Among posts from predominantly family care partners (10,427/11,092, 94%, mostly adult children), 7 themes emerged: Pharmacotherapy (155/300, 51.7%), addressing medication efficacy, polypharmacy, and side effects; Patient Health Care Implementation Strategies (n=125, 41.7%), encompassing care coordination and provider interactions; Comorbid Care Management (n=136, 45.3%), highlighting caregiving demands, behavioral symptoms of ADRD, and care coordination challenges as barriers to hypertension control; Hypertension Management and Outcomes (n=71, 23.7%), including hypertensive crises; Managing Behavioral Symptoms (n=38, 12.7%), particularly care resistance; Peer Medical Advice Exchange (n=9, 3%); and Caregiver Burden and Self-Care for Hypertension (n=25, 8.3%), revealing care partners' own hypertension attributed to caregiving stress. CONCLUSIONS: Managing comorbid hypertension in ADRD presents challenges spanning medication management, behavioral symptoms, and health care coordination. Caregivers reported developing hypertension themselves, highlighting bidirectional health impacts. Health care providers should implement dyadic interventions addressing both patient hypertension management and caregiver health within the care partnership.