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Caregiver Perspectives on Hypertension Management in Alzheimer's Disease and Related Dementias (ADRD) Care: A Qualitative Analysis of Online Community Data
ABSTRACT
Background:
Family caregivers manage care for individuals with Alzheimer's Disease and Related Dementias (ADRD), including hypertension (HTN) management crucial for preventing cognitive decline. Nurses frequently interact with these caregiver-patient dyads but have limited evidence about caregivers' real-world experiences managing this comorbidity. Understanding these experiences is essential for developing nurse-led interventions that support both patients and caregivers.
Objective:
This study explored ADRD caregivers' perceptions, experiences, and challenges related to hypertension management through analysis of online health community posts.
Methods:
We analyzed 300 posts from ALZconnected.org collected using keywords "hypertension" and "blood pressure." Two independent researchers employed reflexive thematic analysis following Braun and Clarke's framework until achieving data saturation.
Results:
Among posts from predominantly family caregivers (94%, mostly adult children), seven themes emerged: Pharmacotherapy (51.7%), addressing medication efficacy, polypharmacy, and side effects; Patient Healthcare Implementation Strategies (41.7%), encompassing care coordination and provider interactions; Comorbid Care Management (45.3%), highlighting ADRD as a barrier to HTN control; HTN Management and Outcomes (23.7%), including hypertensive crises; Managing Behavioral Symptoms (12.7%), particularly care resistance; Medical Advice Exchange (3.0%); and Caregiver Burden and Self-Care (8.3%), revealing caregivers' own HTN attributed to caregiving stress.
Conclusions:
Managing comorbid HTN in ADRD presents challenges spanning medication management, behavioral symptoms, and healthcare coordination. Caregivers reported developing HTN themselves, highlighting bidirectional health impacts. Healthcare providers should implement dyadic interventions addressing both patient HTN management and caregiver health within the care partnership. Clinical Trial: N/A
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.