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Unmet needs in the measurement of blood pressure in primary care
S Zaheer1, L Watson, N J A Webb
1Department of Paediatric Nephrology and NIHR/Wellcome Trust Children's Clinical Research Facility, The University of Manchester, Manchester Academic Health Science Centre, Royal Manchester Children's Hospital, , Manchester, UK.
Insights
Primary care professionals need better equipment and training to effectively monitor blood pressure (BP) in children, as current resources and confidence levels are insufficient for pediatric hypertension screening.
Area of Science:
- Pediatric Hypertension
- Primary Care Medicine
- Clinical Equipment Standards
Background:
- Blood pressure (BP) monitoring for UK children at risk of hypertension primarily occurs in secondary and tertiary care settings.
- This highlights a potential gap in primary care's capacity for early detection and management of pediatric hypertension.
Purpose of the Study:
- To assess the availability of pediatric blood pressure (BP) equipment within primary care (PC) settings.
- To evaluate the confidence levels of primary care professionals in measuring and interpreting children's BP readings.
Main Methods:
- A questionnaire survey was distributed to 103 primary care practices.
- Data collected included the availability of pediatric BP cuffs, validated equipment, and self-reported confidence in BP measurement and interpretation (1-10 scale).
- Cuff size and equipment type were also documented.
Main Results:
- Out of 95 responding practices, only 40 (42%) possessed pediatric BP cuffs.
- Of the devices available, 35 out of 51 (69%) were validated for pediatric use.
- Median confidence in BP measurement was 7/10, but confidence in interpretation was low (3/10), significantly improving to 8/10 when normal ranges were provided (p<0.01).
Conclusions:
- Primary care practices often lack appropriate, validated equipment for pediatric blood pressure monitoring.
- There is a notable deficit in primary care professionals' confidence in interpreting pediatric BP, particularly without reference ranges.
- Investment in both suitable equipment and targeted education is essential to empower primary care to effectively monitor children's BP.
Background:
Blood pressure (BP) monitoring in UK children at risk of hypertension takes place predominantly in secondary and tertiary care.
Objectives:
To investigate (i) the availability of paediatric BP equipment in primary care (PC) and (ii) the confidence of PC professionals in measuring and interpreting children's BP.
Methods:
103 PC practices were approached to complete a questionnaire. BP equipment availability and confidence with BP measurement and interpretation were recorded (interval scale 1-10). Cuff size and equipment type were documented.
Results:
95 (92%) practices responded; 40/95 possessed paediatric BP cuffs. 35/51 devices were validated for paediatric use. Median (IQR) confidence in BP measurement was 7 (2-8). Confidence in BP interpretation was 3 (2-6), though this improved if normal ranges were provided (8 (6-9), p<0.01).
Conclusions:
Investment in appropriate equipment and education is required to allow PC to successfully monitor BP in children.
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