Blood pressure control in treated hypertensive patients: clinical performance of general practitioners.
| Autor: | Frijling BD; Centre for Quality of Care Research, University of Nijmegen, P O Box 9101, 6500 HB Nijmegen, The Netherlands. b.frijling@hsv.kun.nl, Spies TH, Lobo CM, Hulscher ME, van Drenth BB, Braspenning JC, Prins A, van der Wouden JC, Grol RP |
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| Jazyk: | angličtina |
| Zdroj: | The British journal of general practice : the journal of the Royal College of General Practitioners [Br J Gen Pract] 2001 Jan; Vol. 51 (462), pp. 9-14. |
| Abstrakt: | Background: The blood pressure of many treated hypertensive patients remains above recommended target levels. This discrepancy may be related to general practitioners' (GPs') actions. Aim: To assess clinical performance of GPs in blood pressure control in treated hypertensive patients and to explore the influence of patient and GP characteristics on clinical performance. Design of Study: Cross-sectional study conducted on 195 GPs with invitations to participate made via bulletins and by letter. Setting: One hundred and thirty-two practices in the southern half of The Netherlands from November 1996 to April 1997. Method: Performance criteria were selected from Dutch national hypertension guidelines for general practice. GPs completed self-report forms immediately after follow-up visits of hypertensive patients treated with antihypertensive medication. Results: The GPs recorded 3526 follow-up visits. In 63% of these consultations the diastolic blood pressure (DBP) was 90 mmHg or above. The median performance rates of the GPs were less than 51% for most of the recommended actions, even at a DBP of > or = 100 mmHg. Performance of non-pharmacological actions increased gradually with increasing DBP; prescribing an increase in antihypertensive medication and making a follow-up appointment scheduled within six weeks rose steeply at a DBP of > or = 100 mmHg. Patient and GP characteristics contributed little to clinical performance. Action performance rates varied considerably between GPs. Conclusion: GPs seem to target their actions at a DBP of below 100 mmHg, whereas guidelines recommend targeting at a DBP of below 90 mmHg. |
| Databáze: | MEDLINE |
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