Autor: |
Céline Roulet, Zsofia Rozsnyai, Katharina Tabea Jungo, Milly A van der Ploeg, Carmen Floriani, Donata Kurpas, Shlomo Vinker, Sanda Kreitmayer Pestic, Ferdinando Petrazzuoli, Kathryn Hoffmann, Rita P A Viegas, Christian Mallen, Athina Tatsioni, Hubert Maisonneuve, Claire Collins, Heidrun Lingner, Rosy Tsopra, Yolanda Mueller, Rosalinde K E Poortvliet, Jacobijn Gussekloo, Sven Streit |
Jazyk: |
angličtina |
Rok vydání: |
2020 |
Předmět: |
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Zdroj: |
PLoS ONE, Vol 15, Iss 7, p e0236064 (2020) |
Druh dokumentu: |
article |
ISSN: |
1932-6203 |
DOI: |
10.1371/journal.pone.0236064 |
Popis: |
BackgroundThe best management of hypertension in frail oldest-old (≥80 years of age) remains unclear and we still lack guidelines that provide specific recommendations. Our study aims to investigate guideline use in general practitioners (GPs) and to examine if guideline use relates to different decisions when managing hypertension in frail oldest-old.Design/settingCross-sectional study among currently active GPs from 29 countries using a case-vignettes survey.MethodsGPs participated in a survey with case-vignettes of frail oldest-olds varying in systolic blood pressure (SBP) levels and cardiovascular disease (CVD). GPs from 26 European countries and from Brazil, Israel and New Zealand were invited. We compared the percentage of GPs reporting using guidelines per country and further stratified on the most frequently mentioned guidelines. To adjust for patient characteristics (SBP, CVD and GPs' sex, years of experience, prevalence of oldest-old and location of their practice), we used a mixed-effects regression model accounting for clustering within countries.ResultsOverall, 2,543 GPs from 29 countries were included. 59.4% of them reported to use guidelines. Higher guideline use was found in female (p = 0.031) and less-experienced GPs (pConclusionMany GPs reported using guidelines to manage hypertension in frail oldest-old patients, however guideline users did not decide differently from non-users concerning hypertension treatment decisions. Instead of focusing on the fact if GPs use guidelines or not, we as a scientific community should put an emphasis on what guidelines suggest in frail and oldest-old patients. |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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