Background Home blood pressure monitoring (HBPM) could improve blood pressure control through therapeutic adherence. The main objective of this study was to determine the link between HBPM used by hypertensive patients treated in primary care and their medication adherence. Methods Cross-sectional comparative study conducted in the Auvergne region from June to November 2016. Patients were recruited by general practitioners (GPs) selected at random. Adherence was evaluated according to the Girerd score. Results From a sample of eighty-two GPs including 1026 patients, 45% of patients reported owning an HBPM device. Among these, 18% knew the rule of 3 (3 measurements in the morning and 3 in the evening for 3 days) recommended by the French State Health Authority. There was no difference in adherence between patients using HBPM and those who did not. Patients with HBPM using the rule of 3 reported better adherence than patients without the device (p = 0.06), and those who did not perform self-measurements according to the rule of 3 (p = 0.01). Patients who used HBPM according to the rule of 3 were older (p = 0.006) and less smokers (p = 0.001) than the others. Their GPs were more often GP teachers (p < 0.001) who practiced in rural areas (p = 0.001). Conclusion The statistical link between medication adherence and HBPM for patients who apply the rule of 3, emphasizes the importance of the GP educating the patient on the proper use of HBPM.

Background Home blood-pressure measurement (HBPM) is recommended for the diagnosis of hypertension and monitoring of patients with hypertension. Since 2013, the French National Health Insurance Body (FNHIB) has promoted HBPM to general practitioners (GPs). The objective of the study was to evaluate the practice of HBPM by French GPs to diagnose and monitor hypertension, 3 years after the beginning of the FNHIB campaign. Methods We conducted a postal survey from 7 March to 31 May 2016. All of the 1040 GPs practising in the Auvergne region in France were invited to participate, using a self-reporting questionnaire. We obtained information on the characteristics of the GPs, and their practice regarding the use of HBPM. Use of HBPM was reported as “never, occasionally, regularly and systematically”. Frequency of HBMP use was analysed using multivariate ordered logistic regression model. Results A total of 569 (54.7%) GPs responded to the survey. They were 50.3 (± 11.5) years old, 241 (43.0%) were female, and 352 (62.7%) worked in urban areas. Among them, 530 (94.5%) reported the use of HBPM for diagnosis and 519 (92.5%) for monitoring hypertension. To diagnose hypertension, younger GPs (OR = 0.97; 95% CI: 0.95–0.98), GPs practising in a group (OR = 1.45; 95% CI: 1.00–2.10) and in an MHC (OR = 2.09; 95% CI: 1.15–3.78), as compared to GPs with individual practices, and Clinical Tutors, as compared to non-Clinical Tutors, (OR = 1.92; 95% CI: 1.33–2.79) reported more frequent use of HBPM. To manage hypertension, female GPs, as compared to male GPs, (OR=1.47; 95% CI: 1.04–2.06), younger GPs (OR = 0.98; 95% CI: 0.97–0.99), and Clinical Tutors (OR = 1.90; 95% CI: 1.31–2.75) reported more frequent use of HBPM. Conclusions Our survey reveals that 3 years after the introduction of the FNHIB incentives, the use of HBPM by participating GPs to diagnose and manage hypertension is well established. A larger survey of GPs from other regions would make it possible to verify whether our results can be extrapolated to France as a whole.

Contexte. La mesure de la pression artérielle (PA) est un geste rituel dans les consultations de médecine générale. Selon les dernières recommandations, une mesure de la PA tous les trois ans en cas de PA normale chez le sujet sain est suffisante. Objectif. Explorer le ressenti des médecins généralistes (MG) et des patients concernant l’absence de mesure de la PA. Méthode. Étude qualitative par théorisation ancrée. Les MG ont été recrutés de manière aléatoire via l’annuaire des Pages Jaunes et les patients par la méthode « boule de neige ». L’échantillonnage des MG et des patients a été effectué en recherche de variations maximales. Tous les entretiens individuels semi-dirigés ont été codés de manière individuelle puis de manière conjointe. Résultats. Lors des 12 entretiens avec les MG, deux typologies se sont dégagées : une « prise de tension » avec pour objectif de répondre aux attentes supposées des patients (objectif relationnel) et une mesure de PA réalisée avec un objectif médical dans le respect des recommandations. La « prise de tension » semblait favoriser l’inertie thérapeutique, car les MG tenaient moins compte des chiffres. Il y avait une discordance entre les attentes des 9 patients interrogés et celles supposées par les MG. Les patients interrogés n’attendaient pas de mesure systématique à chaque consultation. La relation avec leur MG et la confiance qu’il leur accordait ne dépendait pas de ce geste, mais d’un ensemble de compétences médicales et relationnelles. Conclusion. Il y a une discordance entre les attentes réelles des patients et celles supposées par les MG. Notre hypothèse initiale : « Les patients attendent une mesure systématique de leur PA » est contredite. Les patients pourraient accepter une mesure moins fréquente, mais de meilleure qualité de la PA.

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