Commissioning maternity care: little room for manoeuvre?

Jewell, David

doi:10.3399/bjgp11x601217

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Guidance covers many factors affecting the accuracy of BP measurement, such as the use an appropriately sized cuff, but such factors are less easily assessed by patients and we chose to limit the focus of this study in order to maximise response rates. The type and accuracy of devices used in UK general practice has been studied previously, 27 but further direct observation of clinicians is warranted to determine if other aspects of BP measurement guidance is followed.…”

Section: Discussionmentioning

confidence: 99%

Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective ‘mystery shopper’ study in UK primary care

2018

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ObjectivesHypertension trials and epidemiological studies use multiple clinic blood pressure (BP) measurements at each visit. Repeat measurement is also recommended in international guidance; however, little is known about how BP is measured routinely. This is important for individual patient management and because routinely recorded readings form part of research databases. We aimed to determine the current practice of BP measurement during routine general practice appointments.Design(1) An online cross-sectional survey and (2) a prospective ‘mystery shopper’ study where patients agreed to report how BP was measured during their next appointment.SettingPrimary care.ParticipantsPatient charity/involvement group members completing an online survey between July 2015 and January 2016. 334 participants completed the prospective study (51.5% male, mean age=59.3 years) of which 279 (83.5%) had diabetes.Primary outcomeProportion of patients having BP measured according to guidelines.Results217 participants with (183) and without diabetes (34) had their BP measured at their last appointment. BP was measured in line with UK guidance in 63.7% and 60.0% of participants with and without diabetes, respectively. Initial pressures were significantly higher in those who had their BP measured more than once compared with only once (p=0.016/0.089 systolic and p<0.001/p=0.022 diastolic, in patients with/without diabetes, respectively).ConclusionsCurrent practice of routine BP measurement in UK primary care is often concordant with guidelines for repeat measurement. Further studies are required to confirm findings in broader populations, to confirm when a third repeat reading is obtained routinely and to assess adherence to other aspects of BP measurement guidance.

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Section: Discussionmentioning

confidence: 99%

Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective ‘mystery shopper’ study in UK primary care

2018

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“…A recently conducted study in the UK yielded similar findings indicating measuring accuracy of 86% ( 7 ). Even though our results are comparable with other European countries, it can be argued that 18.6% (11.4% falsely positive, 7.4% falsely negative) inaccurately measuring devices are not acceptable for clinical practice.…”

Section: Discussionmentioning

confidence: 53%

Measuring accuracy of sphygmomanometers in the medical practices of Swiss primary care physicians

Züber

Schäfer

Kaiser³

et al. 2013

European Journal of General Practice

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ObjectiveArterial hypertension has a high prevalence in most countries. Blood pressure measurements are performed frequently by primary care physicians. Recommendations from different societies emphasise the importance of measuring blood pressure with well maintained and calibrated instruments only. Since appropriate quality control measures are lacking the following survey was conducted in the medical practices of Swiss primary care physicians.MethodsThis is a cross-sectional survey with Swiss primary care physicians. Nine hundred and seventy-five sphygmomanometers used in the daily practice of medicine were compared and calibrated against a certified calibrator. The magnitude of the measuring error before and after calibration was determined.ResultsThe proportion of the instruments that measured within the required tolerance of ± 3 mmHg over all measuring ranges was 81.4%. The average maintenance time was 5.6 years (± 3.8), and 97% (n = 353) of these instruments had not been maintained for two years (i.e. the recommended maintenance interval) or more. Two years after maintenance the number of devices with measurement errors of more than ± 3 mmHg increased significantly.ConclusionIn Swiss primary care practices, the majority of upper arm and wrist sphygmomanometers measured blood pressure within a tolerance of ± 3 mmHg despite low adherence to the recommended maintenance interval. Two years after maintenance the number of sphygmomanometers with measurement errors increased significantly.

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Commissioning maternity care: little room for manoeuvre?

Cited by 2 publications

References 5 publications

Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective ‘mystery shopper’ study in UK primary care

Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective ‘mystery shopper’ study in UK primary care

Measuring accuracy of sphygmomanometers in the medical practices of Swiss primary care physicians

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