Self-reported hypertension treatment beliefs and practices of primary care physicians in a managed care organization.
Self-reported hypertension treatment beliefs and practices of primary care physicians in a managed care organization.
复制标题
管理医疗组织中初级保健医生自我报告的高血压治疗信念和实践。
DOI：
10.1016/j.amjhyper.2004.10.030
复制
发表时间：
2005
影响因子：
3.2
通讯作者：
GrimmJr,RichardH
中科院分区：
文献类型：
--
作者：
Margolis,KarenL;Rolnick,SharonJ;Fortman,KristineK;Maciosek,MichaelV;Hildebrant,CarrieL;GrimmJr,RichardH
BackgroundBlood pressure (BP) is controlled to recommended goal in less than one-third of people with hypertension. There has been little recent research on physician beliefs and practices with regard to the treatment of hypertension.MethodsIn late 1999, we surveyed 104 primary care physicians in the 18 owned clinics of a large staff model, non-profit health maintenance organization. The survey included questions about demographics, BP treatment goals for patients with uncomplicated hypertension, and beliefs about hypertension.ResultsThe reported systolic BP treatment goal was ≤140 mm Hg for 97% and the diastolic BP goal was ≤90 mm Hg for 100%. The systolic BP goal for patients with isolated systolic hypertension was ≤140 mm Hg for 82%, but 34% stated that they would treat to a different goal depending on the diastolic BP. The proportions of physicians who would intensify treatment for BP of 140/90 mm Hg, 150/95 mm Hg, 165/75 mm Hg, and 165/65 mm Hg were 64%, 97%, 89% and 77%, respectively. Although 93% believed that medication was necessary to control BP in most cases, a majority (55%) agreed with the statement that BP could be controlled in most patients with only one drug. Although 42% reported that they often had to change drugs because of side effects, only 16% believed that it was time-consuming to find a well-tolerated drug regimen.ConclusionsIn this setting, primary care physicians’ self-reported practices were in good agreement with national guidelines put forth in the late 1990s, and their beliefs were favorable to therapy. Our data point to a need for interventions to emphasize that combination drug therapy is frequently required to achieve BP control, and that more aggressive intervention is often warranted for isolated systolic hypertension. Am J Hypertens 2005;18:566–571 © 2005 American Journal of Hypertension, Ltd.
