Physicians’ Perceptions and Adherence to Guidelines for the Management of Hypertension: A National, Multicentre, Prospective Study

Abstract

Background. The aim of the current study was to investigate physicians' perceptions and adherence to the European guidelines for the management of hypertension. Methods. This is a national, multicentre, prospective, observational study, conducted between November 2007 and June 2008, in Cyprus. Consecutive hypertensive patients have been recruited by a random sample of physicians. The physicians' recommendations for every single patient have been recorded and compared with the 2007 ESH/ESC guidelines. Results. Of the total of 654 patients, 477 (72.9%) were correctly advised by their physician to receive antihypertensive treatment to control their blood pressure, while 396 (60.5%) correctly got advices to adopt only lifestyle changes. The overall adherence of physicians to the European guidelines (overall agreement rate) was 70.4% (k = 0.258, P < 0.001). Of the total of 68 physicians, 65 (95.6%) reported that they were aware of some guidelines. There was no statistically significant effect of specific physicians' characteristics on the overall adherence to guidelines, but there was in the percentage of patients achieving medication guidelines. Conclusions. The study demonstrated that although Cypriot physicians declared that they were aware of the clinical guidelines for the management of hypertension, more than one-fourth of high risk hypertensive patients remained untreated and 40% of low risk patients received inappropriate medication.

Health Behaviors and Health Status among Middle-Aged and Older Adults with Chronic Diseases in Taiwan

“…Studies have also revealed that changes in lifestyle patterns through the adoption of health behaviors can effectively improve an individual’s health conditions or alleviate symptoms of chronic diseases. For example, reduced intake of sodium, regular exercise, no smoking, and limited drinking are all recommended methods for controlling chronic diseases [ 10 , 11 , 12 ]. Previous findings have indicated that changes in lifestyle patterns exhibited by healthy individuals or individuals who have chronic diseases can be grouped into clusters [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”

“…Unhealthy lifestyle behaviors are associated with poor health status; however, these behaviors are modifiable. Researchers have discussed that changes in lifestyle patterns or adoption of health behaviors may effectively improve the conditions of those with chronic diseases, such as hypertension and diabetes [ 10 , 11 , 12 ]. Therefore, positive changes in health behaviors by reducing the identified modifiable lifestyle risk factors could prevent specific chronic diseases and promote health, thereby confirming the importance of preventive medicine.…”

“…Studies have examined whether the early detection, diagnosis, and immediate treatment of diseases can reduce the risk of developing permanent disabilities and explored corresponding health service utilization and expenditure at the secondary level [ 37 , 38 , 39 , 40 , 41 ]. However, only a few studies have examined health strategies such as health behaviors and their effect on the health promotion of individuals with chronic diseases at the tertiary level [ 10 , 11 , 12 , 42 ]. Therefore, this study analyzed the relationship between health behavior clusters and health status among middle-aged and older adults with chronic diseases at the tertiary level.…”

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“…For example, Theodorou et al studied adherence to European guidelines for the management of hypertension and found that even though physicians were aware of the clinical guidelines and the majority of patients received appropriate treatment advice and lifestyle recommendations, more than one fourth of high-risk hypertensive patients remained untreated and 40 % of low-risk patients received inappropriate medications [38]. Another study showed poor adherence to guidelines in hypertensive patients with diabetes and left ventricular hypertrophy [39].…”

Calidad de la prescripción de verapamilo de liberación convencional en pacientes con hipertensión arterial

“…No deja de ser preocupante el número de pacientes que reciben este medicamento como parte de su terapia antihipertensiva, puesto que los someten a un riesgo documentado largo tiempo atrás y cuyas causas pueden estar relacionadas con una falta de actualización por parte de los clínicos responsables de su atención, carencia de programas de educación médica continua y por falta de adherencia a las guías de práctica clínica que desde hace muchos años no consideraban al verapamilo en esta presentación como terapia antihipertensiva 13,14 . Por otro lado, se pudieron identificar las variables que se asociaron con incremento del riesgo de conseguir el cambio de la terapia con VLC por otro antihipertensivo, y de aquellas que reducían dicha probabilidad.…”