Adherence of primary care physicians to recommended guidelines for blood pressure measurement

Yıl 2020, Cilt: 45 Sayı: 4, 1617 - 1624, 27.12.2020

Çağatay Çavuşoğlu , Ahmet Alper Kıykım , Kenan Turgutalp , Simge Bardak

Öz

Purpose: Accurate blood pressure measurement (BPM) is the main point for the proper diagnosis and management of hypertension. In this paper, we aim to assess the approaches taken by family physicians (FPs) about BPM and blood pressure measurement devices’ (BPMDs) standards.
Materials and Methods: A survey was prepared in accordance with the current hypertension guidelines to assess the knowledge and awareness of FPs about BPM methods and BPMDs’ standards. Questionnaires were filled out face-to-face with family physicians.
Results: In total, 300 of 412 local FPs were included in this study. Office BPMs were preferred by 41.7% of physicians, whereas 42.7% expressed their preference for HBPMs for hypertension diagnosis and treatment. Aneroid devices were chosen by 61.3% of FPs who believed that their knowledge and skills about BPM were excellent. The rate of FPs who preferred devices not compatible with one of the recommended devices in the guidelines was 79.7%. A total of 53% of FPs recommended upper arm automatic BPMDs to their patients and only 25% of FPs recommended BPMDs proved by clinical studies.
Conclusion: We concluded that the awareness, knowledge, and routine daily practice of FPs in Mersin regarding BPM and BPMDs are poor and need to be improved. The results of this study may help us to question the approaches of FPs to hypertensive patients and may improve HT management.

Anahtar Kelimeler

hypertension, blood pressure measurement device, home blood pressure, family physicians

Kan basıncı ölçümünde birinci basamak sağlık hizmetlerinde görev alan hekimlerin güncel kılavuzlara uyumu

Öz

Amaç: Hipertansiyon tanı ve tedavisinde, en önemli nokta kan basıncının doğru ölçülmesidir. Çalışmamızda aile hekimlerinin kan basıncı ölçüm metotları ve kan basıncı cihaz standartları hakkındaki yaklaşımlarını değerlendirmeyi amaçladık.
Gereç ve Yöntem: Aile hekimlerinin hipertansiyon ölçümmetotları ve hipertansiyon ölçüm cihazları hakkındaki farkındalıklarını ve bilgilerini değerlendirmek amacıyla güncel hipertansiyon kılavuzlarna uygun olarak bir anket hazırlandı. Anketler aile hekimleri ile yüz yüze doldurulmuştur.
Bulgular: Toplamda 412 aile hekiminden 300’ü çalışmaya dahil edildi. Hipertansiyon tanı ve tedavisinde hekimlerin %41.7’si ofis ölçümünü , %42.7’si evde kan basıncı ölçümünü tercih etti. Kan basıncı ölçümleri hakkındaki bilgi ve becerilerinin mükemmel olduğunu düşünen aile hekimlerin %61.3’ü aneroid cihazı tercih etti. Kılavuzlar tarafından önerilen cihazlara uygun olmayan cihazları tercih eden aile hekimlerinin oranı %79.7’idi. Aile hekimlerinin 553.7’si hastalarına otomatik üst kol tansiyon cihazı tavsiye ederken, sadece %25’i klinik çalışmalarla önerilen tansiyon ölçüm cihazlarını tavsiye etti.
Sonuç: Çalışmamızda Mersin’deki aile hekimlerinin günlük partiklerinin, tansiyon ölçümü ve ölçüm cihazları hakkındaki bilgi ve farkındalık seviyelerinin düşük düzeyde olduğu ve geliştirilmesi gerektiğinin farkına vardık. Çalışmamızın sonuçları, aile hekimlerinin hipertansiyon hastalarına yaklaşımını sorgulamamıza ve hipertansiyon yöntemini geliştirmeye yardımcı olabilir.

Anahtar Kelimeler

hipertansiyon, kan basıncı ölçüm cihazı, evde kan basıncı

Kaynakça

• 1. Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3:3423-32.
• 2. Altun B, Arici M, Nergizoglu G, Derici U, Karatan O, Turgan C et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23:1817-23.
• 3. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.
• 4. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M et al. 2013 ESH/ESC Practice guidelines for the management of arterial hypertension. Blood Press. 2014;23:3-16.
• 5. Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39:3021-104.
• 6. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood Press. 2013;22:193-278.
• 7. Rouse A, Marshall T. The extent and implications of sphygmomanometer calibration error in primary care. J Hum Hypertens. 2001;15:587-91.
• 8. Akpolat T, Dilek M, Aydogdu T, Adibelli Z, Erdem DG, Erdem E. Home sphygmomanometers: validation versus accuracy. Blood Press Monit. 2009;14:26-31.
• 9. Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res. 2014;37:253-390.
• 10. Dasgupta K, Quinn RR, Zarnke KB, Rabi MD, Ravani P, Daskalopulcu SS et al. The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2014;30:485-501.
• 11. Arıcı M, Birdane A, Güler K, Yildiz BO, Altun B, Erturk S et al. Türk hipertansiyon uzlaşı raporu (Turkish Hypertension Consensus Report). Turk Kardiyol Dern Ars. 2015;43:402-9.
• 12. Bliziotis IA, Destounis A, Stergiou GS. Home versus ambulatory and office blood pressure in predicting target organ damage in hypertension: a systematic review and meta-analysis. J Hypertens. 2012;30:1289-99.
• 13. Sheppard JP, Schwartz CL, Tucker KL, McManus RJ. Modern management and diagnosis of hypertension in the United Kingdom: Home Care and Self-care. Ann Glob Health. 2016;82:274-87.
• 14. Rustagi N, Singh R. Mercury and health care. Indian J Occup Environ Med. 2010;14:45-8.
• 15. Harris KC, Benoit G, Dionne J, Cloutier L, Zarnke BK, Padwal RS et al. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for blood pressure measurement, diagnosis, and assessment of risk of pediatric hypertension. Can J Cardiol 2016;32:589-97.
• 16. Vischer AS, Burkard T. Principles of blood pressure measurement – Current techniques, office vs ambulatory blood pressure measurement. Adv Exp Med Biol. 2017;956:85-96.
• 17. Akpolat T, Erdem Y, Derici U, Erturk S, Caglar S, Hasanoglu E et al. Use of home sphygmomanometers in Turkey: a nation-wide survey. Hypertens Res. 2011;35:356-61.
• 18. White WB, Berson AS, Robbins C, et al. National standard for measurement of resting and ambulatory blood pressures with automated sphygmomanometers. Hypertension. 1993;21:504-9.
• 19. O'Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R et al. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit. 2010;15:23-38.
• 20. O'Brien E, Waeber B, Parati G, Staessen J, Myers MG. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ. 2001;322:531-6.
• 21. Tholl U, Lüders S, Bramlage P, Dechend R, Eckert S, Mengden T et al. The German Hypertension League (Deutsche Hochdruckliga) Quality Seal Protocol for blood pressure-measuring devices: 15-year experience and results from 105 devices for home blood pressure control. Blood Press Monit. 2016;21:197-205.