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Related Experiment Videos

Delphi panel study of current hypertension treatment patterns.

A Richter1, C Ostrowski, M P Dombeck

  • 1Research Triangle Institute, Research Triangle Park, North Carolina 27709, USA. anke@rti.org

Clinical Therapeutics
|February 24, 2001
PubMed
Summary
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Physician practices for managing mild to moderate hypertension often differ from JNC-VI guidelines. This study used a Delphi panel to identify these differences for cost-effectiveness modeling.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Health Services Research

Background:

  • Current clinical practice for managing mild to moderate hypertension may not align with established guidelines.
  • The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) provides specific recommendations.
  • Understanding practice variations is crucial for improving patient outcomes and healthcare efficiency.

Purpose of the Study:

  • To compare usual physician practices in managing mild to moderate hypertension against JNC-VI recommendations.
  • To gather data on physician consensus regarding hypertension definitions, treatment, and follow-up for a cost-effectiveness model.

Main Methods:

  • A Delphi panel survey was administered to U.S. general practitioners and cardiologists.

Related Experiment Videos

  • The survey focused on reaching consensus on JNC-VI guidelines for defining hypertension, treatment strategies, and patient follow-up.
  • Ten physicians completed both rounds of the questionnaire.

    • Main Results:

    • Significant variation exists in how physicians define blood pressure ranges, often citing higher limits than JNC-VI.
    • Physicians adhered to JNC-VI guidelines approximately 60% of the time.
    • Comorbidities and hypertension severity primarily influenced initial drug choice, with patient demographics being secondary. Follow-up protocols varied.
    • Dose titration occurred 1-2 times before discontinuation for lack of efficacy, with routine follow-up every 3-4 months post-control.

    Conclusions:

    • Clinical practice patterns for hypertension management show notable divergence from JNC-VI guidelines.
    • The study identified specific areas of discrepancy in practice, informing the development of a cost-effectiveness model.
    • The findings provide essential data on management and prescribing patterns for hypertension models.