Conducta del médico de atención primaria ante el mal control de la hipertensión arterial. Estudio PRESCAP 2010

Moreno, F.J. Alonso; Llisterri, J.L.; Roca, G.C. Rodríguez; Díaz, M.A. Prieto; Garrote, J.A. Divisón; Alonso, Vivencio Barrios; Altozano, C. Santos; Madueño, M. Ferreiro; Banegas, José R.; Alsina, Diego González-Segura

doi:10.1016/j.semerg.2012.05.007

Cited by 14 publications

(8 citation statements)

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“…Although PRESCAP 2010, a cross-sectional multicenter study conducted in Spain, investigated how primary care physicians manage hypertension in routine practice, it did not consider factors related to either empathy or burnout [28]. In our study population, high empathy was significantly associated with low burnout, supporting the theory that actions designed to improve communication skills and empathic tendencies among health care professionals could help to mitigate burnout.…”

Section: Discussionsupporting

confidence: 53%

Occupational burnout and empathy influence blood pressure control in primary care physicians

Yuguero

Marsal

Esquerda³

et al. 2017

BMC Fam Pract

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BackgroundGood physician-patient communication can favor the adoption of healthy lifestyle habits, which is essential in high blood pressure (BP) management. More empathic physicians tend to have lower burnout and better communication skills. We analyzed the association between burnout and empathy among primary care physicians and nurses and investigated the influence on BP control performance.MethodsDescriptive study conducted in 2014 investigating burnout and empathy levels in 267 primary care physicians and nurses and BP control data for 301,657 patients under their care. We administered the Maslach Burnout Inventory and the Jefferson Scale of Physician Empathy and defined good BP control as a systolic BP <130 mmHg.ResultsLow burnout and high empathy were observed in 58.8% and 33.7% of practitioners, respectively. Burnout and empathy were significantly negatively associated (p < 0.009). Practitioners with high empathy and low burnout had significantly better BP control and performance than those with low empathy and high burnout (p < 0.05).ConclusionsLow burnout and high empathy were significantly associated with improved BP control and performance, possibly in relation to better physician/nurse-patient communication.

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Section: Discussionsupporting

confidence: 53%

Occupational burnout and empathy influence blood pressure control in primary care physicians

Yuguero

Marsal

Esquerda³

et al. 2017

BMC Fam Pract

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“…[19][20][21] In the CardioMonitor survey 21 of 21 053 patients with hypertension in Western Europe and the US, there were 11 969 patients with inadequately controlled hypertension, of whom only 15% to 38% received treatment intensification, with rates of 13% to 42% reported in other large studies. 19,20,22 These findings are consistent with usual care in the present study, in which treatment intensification occurred in 35.2% to 36.0% of visits at which BP was not controlled; however, a novel finding was that therapeutic inertia rates were even higher in the triple pill group during follow-up, with only 10.0% to 13.2% who did not achieve BP targets receiving treatment intensification in this group. The lower rate of treatment intensification in the triple pill group was partly due to their lower SBP levels, with fewer patients having an SBP more than 10 mm Hg above the BP target.…”

Section: Discussionsupporting

confidence: 89%

“…In the Reasons for not Intensifying Antihypertensive Therapy (RIAT) study 20 of 35 302 patients, the main reasons for not intensifying antihypertensive treatment when BP remained above target were the assumption that the interval after starting the new drug was too short to attain its full effect, the satisfaction with a clear improvement of BP or with a BP nearing the target, and the acceptance of good selfmeasurements. Similarly, in the PRESCAP cross-sectional study 22 of 12 961 patients, the physicians' perception of good BP control in uncontrolled patients together with the pres-ence of multiple antihypertensive agents were the 2 variables most strongly associated with therapeutic inertia.…”

Section: Discussionmentioning

confidence: 92%

Association of Low-Dose Triple Combination Therapy With Therapeutic Inertia and Prescribing Patterns in Patients With Hypertension

et al. 2020

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for the TRIUMPH Study Group IMPORTANCE Fixed-dose combination (FDC) therapies are being increasingly recommended for initial or early management of patients with hypertension, as they reduce treatment complexity and potentially reduce therapeutic inertia.OBJECTIVE To investigate the association of antihypertensive triple drug FDC therapy with therapeutic inertia and prescribing patterns compared with usual care. DESIGN, SETTING, AND PARTICIPANTSA post hoc analysis of the Triple Pill vs Usual Care Management for Patients With Mild-to-Moderate Hypertension (TRIUMPH) study, a randomized clinical trial of 700 patients with hypertension, was conducted. Patients were enrolled from 11 urban hospital clinics in Sri Lanka from February 2016 to May 2017; follow-up ended in October 2017. Data were analyzed from September to November 2019.INTERVENTIONS Once-daily FDC antihypertensive pill (telmisartan, 20 mg; amlodipine, 2.5 mg; and chlorthalidone, 12.5 mg) or usual care.MAIN OUTCOMES AND MEASURES Therapeutic inertia, defined as not intensifying therapy in those with blood pressure (BP) above target, was assessed at baseline and during follow-up visits. Prescribing patterns were characterized by BP-lowering drug class and treatment regimen potency. Predictors of therapeutic inertia were assessed with binomial logistic regression. RESULTSOf the 700 included patients, 403 (57.6%) were female, and the mean (SD) age was 56 (11) years. Among patients who did not reach the BP target, therapeutic inertia was more common in the triple pill group compared with the usual care group at the week 6 visit (92 of 106 [86.8%] vs 124 of 194 [63.9%]; P < .001) and week 12 visit (81 of 90 [90%] vs 116 of 179 [64.8%]; P < .001). At the end of the study, 221 of 318 patients in the triple pill group (69.5%) and 182 of 329 patients in the usual care group (55.3%) reached BP targets. Among those who received treatment intensification, the increase in estimated regimen potency was greater in the triple pill group compared with the usual care group at baseline (predicted mean [SD] increase in regimen potency: triple pill, 15 [6] mm Hg; usual care, 10 [5] mm Hg; P < .001), whereas there were no significant differences at the week 6 or at week 12 visit. Clinic systolic BP level was the only consistent predictor of treatment intensification during follow-up. During follow-up, there were 23 vs 54 unique treatment regimens per 100 treated patients in the triple pill vs usual care groups, respectively (P < .001). CONCLUSIONS AND RELEVANCETriple pill FDC therapy was associated with greater rates of therapeutic inertia compared with usual care. Despite this, triple pill FDC therapy substantially simplified prescribing patterns and improved 6-month BP control rates compared with usual care. Further improvements in hypertension control could be achieved by addressing therapeutic inertia among the minority of patients who do not achieve BP control after initial FDC therapy.

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“…La primera vía de control de esta enfermedad es de tipo farmacológica (Instituto Mexicano del Seguro Social, 2008). No obstante, mantener los niveles de presión arterial dentro de los parámetros normales ha resultado un desafío, ya que a pesar del consumo de medicamentos, muchos pacientes siguen presentando valores elevados de presión arterial (Moreno, Caro, Rodríguez-Roca, Prieto-Díaz, División-Garrote, 2010).…”

Section: Introductionunclassified

Personalidad y estado afectivo en personas con normo e hipertensión

Rojas-Vite

Salgado

2021

ESA

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Se realizó un estudio piloto con 8 personas con hipertensión arterial bajo tratamiento farmacológico, pacientes de consulta externa del Hospital General de Pachuca, y 8 participantes voluntarios con presión arterial dentro de los parámetros normales. Se tomaron medidas de presión arterial sistólica y diastólica, índice de masa corporal, personalidad y estado afectivo. No se encontraron diferencias con significancia estadística en cuatro de los 5 factores de personalidad, excepto en el factor neuroticismo, el cual tuvo un nivel más alto en el grupo con hipertensión. El estado afectivo negativo y positivo fue equivalente en ambos grupos. Estos resultados son una guía para futuras investigaciones e intervenciones que tengan como fin promover la salud integral en el paciente con hipertensión arterial.

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Conducta del médico de atención primaria ante el mal control de la hipertensión arterial. Estudio PRESCAP 2010

Cited by 14 publications

References 27 publications

Occupational burnout and empathy influence blood pressure control in primary care physicians

Occupational burnout and empathy influence blood pressure control in primary care physicians

Association of Low-Dose Triple Combination Therapy With Therapeutic Inertia and Prescribing Patterns in Patients With Hypertension

Personalidad y estado afectivo en personas con normo e hipertensión

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