DOCTOR-CENTERED VERSUS PATIENT CENTERED CARE: EFFECT ON PATIENT ENABLEMENT AMONG ADULT HYPERTENSIVES AT A GENERAL OUT-PATIENT CLINIC IN AFRICA.

Introduction and objective: Doctor-centered care is routinely practiced in African out-patient clinics and has been criticised for failing to enable patients as equal stakeholders. This study’s aim was to determine if Patient-centered care was a better approach in the management of hypertension using patient enablement as a quality indicator. Methods: This was a RCT involving 84 patients aged 18 years and above. The study groups comprised of newly diagnosed and known hypertensives attending the General Outpatient Clinic (GOPC) of the Jos University Teaching Hospital, Nigeria. The intervention was consultation based on patient centered care while the control group received routine care. Patient enablement and adherence were assessed using the Patient Enablement Index (PEI) and Medical Outcomes Study General Adherence Scale respectively. Follow-up continued for 12 weeks during which BP measurements, assessment for patient enablement and adherence were repeated bi-weekly. Results and Conclusion: : At the end of the study, mean PEI score for the intervention group was slightly higher than the control group. (11.8 vs 11.5, p =0.2). No statistically significant difference was observed for adherence. However, the intervention group showed a sustained increase in the trend for adherence. Both groups had similar BP control rates. A statistically significant association between proportion of patients with good PEI scores and those with controlled BP was observed for both groups. ( χ2 10.3, df 2, p =0.01). While this study established a positive relationship between patient enablement and BP control, the intervention yielded minimal benefit compared to usual care in this African setting.