Assessment of Medical Care Strategies for Primary Hypertension in Iraqi Adults: A Hospital-Based Problem-Oriented...

This study aimed to assess the medical care strategies for primary Hypertension in Iraqi adults through a hospital-based problem-oriented plan to improve patient outcomes by identifying and addressing medical problems.

This cross-sectional study was conducted in a hospital setting of Iraqi adults diagnosed with primary hypertension. Data collection involved patient interviews, medical record reviews, and measurements of blood pressure (BP). The assessment of medical problem-oriented plans (MPOPs) was performed using the validated Alsayed_v1 tool, which includes three main components: the assessment of treatments, the MPOP classification system, and the care plan.

The study participants of 80 Iraqi patients had a mean age of 52.3 years, with 55% male and 45% female. Common comorbid conditions included diabetes mellitus (40%), chronic kidney disease (30%), and coronary artery disease (20%). The most commonly prescribed antihypertensive medications were angiotensin-converting enzyme inhibitors (ACEI) (75.00%). On average, participants were taking 2.087 antihypertensive medications (SD = 0.60), with the majority (63.75%) using a combination of two medications. However, the average BP among participants was 148/92 mmHg, indicating uncontrolled hypertension in most cases (90%). The study identified an average of 3.2 MPOPs per patient, with the most common being inappropriate drug selection (25%), incorrect dosage regimen (20%), and non-adherence to treatment (15%). The chi-squared analysis revealed a significant association between gender and blood pressure status (Χ² = 4.366, p = 0.037). Additionally, the study identified 233 MPOPs across four categories: Indication (23.18%), Effectiveness (53%), Safety (7%), and Patient-related issues (17%). A multiple regression analysis was performed to identify predictors of the number of MPOPs with which heart failure was a significant predictor (β = 4.931, p = 0.003).

The findings highlight the complexity of managing hypertension in Iraqi adults and underscore the need for personalized treatment plans to address the medical problems. Implementing a problem-oriented approach in clinical practice can lead to better BP control and improved health outcomes. This study provides valuable insights for healthcare providers and policymakers to enhance hypertension management strategies in Iraq. However, the study's findings should be interpreted with caution due to limitations such as a relatively small and specific sample, reliance on self-reported data, and the cross-sectional design, which restricts causal inference.