Variation between pragmatic and standardised blood pressure measurements in a Nigerian primary care clinic
| Autor: | Babajide Adekoyejo Taiwo, Ademola O. Egunjobi, Ibrahim B. Ghazali, Oluwaseun S. Ojo, Nurudeen Adigun Gbadamosi, Odunola O. Ojo, Bolatito B. Fatusin, Akinfemi J. Fatusin |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
blood pressure measurement Cross-sectional study Diastole lcsh:Medicine Nigeria usual-care guideline concordant family practice clinic primary care Blood Pressure Reference range 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine 030212 general & internal medicine Original Research Primary Health Care business.industry lcsh:R Limits of agreement Significant difference Public Health Environmental and Occupational Health Blood Pressure Determination Primary care clinic Cross-Sectional Studies Blood pressure Treatment decision making Family Practice business |
| Zdroj: | South African Family Practice South African Family Practice; Vol. 62 No. 1 (2020) South African Family Practice, Vol 62, Iss 1, Pp e1-e11 (2020) |
| ISSN: | 2078-6204 2078-6190 |
| Popis: | Background: A significant difference in the blood pressure (BP) value of a patient taken by different health workers has been a subject of discussion among health workers. This study investigated the variations between usual-care and guideline-concordant BP measurement protocols and evaluated the implications of the disparities on diagnosis and treatment decision. Methods: A cross-sectional study was conducted among 206 participants. The usual-care and guideline-concordant BP readings taken from each participant by the regular clinic nurses and research-trained nurses, respectively, were obtained. Results: Majority of the regular clinic nurses following the usual-care protocol used the left arm for BP measurement (59.7%). The systolic BP (SBP) and diastolic BP (DBP) readings were higher on the right arm in 55.3% and 39.2% of the participants, respectively. The mean guideline-concordant BP was 7.67 mmHg higher than the mean usual-care for SBP ( p ≤ 0.05) and 7.14 mmHg higher for DBP ( p ≤ 0.05). The proportion of participants classified as having hypertension and uncontrolled BP was 11.8% and 15.0% lower when using usual-care BP compared to guideline-concordant BP, respectively. Fifty-one (24.8%) respondents were advised incorrect treatment based on usual-care BP measurement. The Bland-Altman plot showed that limits of agreement were wider than within the 10 mmHg clinical reference range and unacceptable for clinical purposes. Conclusion: The usual-care and guideline-concordant BP measurement protocols were significantly different, and the disparity had significant consequences on the diagnosis and treatment of hypertension. Health workers should strictly adhere to the guidelines on BP measurement to avoid mismanagement of patients. |
| Databáze: | OpenAIRE |
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