Patient personas exemplifying behavioural barriers and enablers to patient education across the hypertension journey: A qualitative framework analysis.

Background.Only one in five people with hypertension have their blood pressure (BP) controlled (<140/90 mmHg). Patient education improves BP control, yet there is limited guidance to adapt to individuals evolving needs across the hypertension management journey. This study aimed to identify key behavioural barriers and enablers to patient education throughout the hypertension management journey, which were synthesised into patient personas to support translation and practical application. Methods.Qualitative interviews with adults ([&ge;]18) who self-monitor BP, and primary care providers involved in hypertension care. Interviews explored the experience of accessing and delivering patient education for BP measurement and management. Using framework analysis, patient personas were developed in three steps: 1) thematic analysis of patient interviews to identify key barriers and enablers to hypertension patient education and mapping the identified barriers and enablers to key time-points in the hypertension journey (diagnosis, treatment initiation, long-term management), 2) clustering behavioural factors via the capability, opportunity, motivation-behaviour model, which were then synthesised as preliminary patient personas and refined using practitioner interviews and, 3) validation by consumer consultation feedback sessions. Results.Patients (n=27) and practitioners (n=12; n=4 general practitioners, n=4 nurses, and n=4 pharmacists) were aged 18-60 years (52% of patients and 100% of practitioners fell within this age range). Several behavioural barriers to patient education for hypertension management included patient overwhelm, inconsistent guidance provided by health professionals, and perceived patient disengagement, while a strong desire to self-manage was a consistent enabler. Six clusters of behavioural barriers and enablers were synthesised as patient personas, capturing the factors that shape education needs and experiences across the hypertension management journey. Conclusions.The patient personas highlight opportunities for tailored patient education strategies through the development of patient personas. Practice implications.The patient personas provide a practical tool for designing person-centred interventions in primary care.