• Hanna Vestala, Marcus Bendtsen, Patrik Midlöv, Karin Kjellgren, and Ann Catrine Eldh.
• Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden.
• Scand J Prim Health Care. 2024 Mar 1; 42 (1): 225233225-233.

ObjectiveTo estimate the effects of an interactive web-based support system via mobile phone on preference-based patient participation in patients with hypertension treated in primary care (compared with standard hypertensive care only).DesignA parallel group, non-blinded, randomized controlled trial, conducted October 2018-February 2021. Besides standard hypertensive care, the intervention group received eight weeks of support via mobile phone to facilitate self-monitoring and self-management, tentatively providing for augmented patient engagement.Setting31 primary healthcare centers in Sweden.Subjects949 patients treated for hypertension.Main Outcome MeasuresThe effects on preference-based patient participation, that is, the match between a patient's preferences for and experiences of patient participation in their health and healthcare. This was measured with the 4Ps (Patient Preferences for Patient Participation) tool at baseline, after 8 weeks, and at 12 months. Data were registered electronically and analyzed with multilevel ordinal regression.ResultsAt baseline, 43-51% had a complete match between their preferences for and experiences of patient participation. There was an indication of a positive effect by a higher match for 'managing treatment myself' at 8-weeks in the intervention group. Such preference-based participation in their health and healthcare was reversed at 12 months, and no further effects of the intervention on preference-based patient participation persisted after 12 months.ConclusionThe interactive web-based support system via mobile phone had a wavering effect on preference-based patient participation. There is a prevailing need to better understand how person-centered patient participation can be facilitated in primary care.

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