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Compliance with hypertension guidelines in general practice in Slovenia
Marija Petek-Ster1, Janko Kersnik, Igor Svab
1Health Center Trebnje, Slovenia. marija.petek-ster@mf.uni-lj.si
Insights
Hypertension guideline compliance in Slovenian primary care is low, with few patients meeting targets. Improved implementation is needed for better hypertension management.
Area of Science:
- Cardiology
- Primary Care Medicine
- Public Health
Background:
- General practice compliance with hypertension guidelines is poorly understood globally.
- No prior data existed on Slovenian general practitioners' adherence to hypertension management guidelines.
Purpose of the Study:
- To assess Slovenian general practitioners' management of hypertensive patients.
- To evaluate adherence to the 1999 World Health Organization/International Society of Hypertension (WHO/ISH) guidelines.
Main Methods:
- 42 family physicians recorded hypertension management data from 300 consecutive patient visits.
- Data was extracted from paper medical records for 2752 hypertensive patients.
Main Results:
- Only 9.3% of patients were managed completely according to guidelines.
- 15.5% of patients achieved target blood pressure values.
- While drug therapy (97.6%) and follow-up (55.3%) showed some adherence, diagnostic programs (23.8%) and overall management were suboptimal.
Conclusions:
- The influence of hypertension guidelines on daily primary care practice appears minimal.
- Effective implementation strategies for hypertension guidelines are crucial in primary care settings.
Introduction:
Compliance with hypertension guidelines in clinical practice is generally poor, but there was no data about compliance with any guidelines in general practice in Slovenia.
Objective:
Our aim was to find out whether general practitioners in Slovenia managed their hypertensive patients according to the national guidelines, based on 1999 WHO/ISH guideline recommendations.
Method:
42 family physicians registered all patients with the diagnosis of arterial hypertension among 300 consecutive regular office visits. We used data about blood pressure management from paper medical records.
Results:
We collected data from 2752 patients with hypertension; the mean age was 64.1 years (SD = 12.4 years, from 21 to 97 years). All elements of the minimal diagnostic program in the last five years were performed in 23.8% of the patients. In 1809 (65.7%) patients, whose cardiovascular risk was estimated, the minimal diagnostic program was performed more frequently (p < 0.001). Non-pharmacological measures were performed in 1210 (47.0%) patients. 2649 (97.6%) patients had drug therapy in accordance with the guidelines. Follow-up in accordance with the guidelines was performed in 1492 (55.3%) patients. Only 256 (9.3%) patients were managed completely according to the guidelines and only 347 (15.5%) of study population reached the target values of blood pressure.
Conclusion:
The impact of hypertension guidelines on patients' management in everyday primary care appears marginal. More emphasis should be placed on the efficient implementation of the guidelines.
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