ArticleBMC public health2003
Generalizability of guidelines and physicians' adherence. Case study on the Sixth Joint National Commitee's guidelines on hypertension.
Article in BMC public health, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Brazilian pediatricians' adherence to food allergy guidelines-A cross-sectional study.PloS one · 2020Article
- Article
- Underprescription of beneficial medicines in older people: causes, consequences and prevention.Drugs & aging · 2012Review
- Explicit criteria for potentially inappropriate medications to reduce the risk of adverse drug reactions in elderly people: from Beers to STOPP/START criteria.Drug safety · 2012Review
- Outpatient antihypertensive drug utilization in Canton Sarajevo during five years period (2004-2008) and adherence to treatment guidelines assessment.Bosnian journal of basic medical sciences · 2011Article
- Quality of care measures for the treatment of bipolar disorder.The Psychiatric quarterly · 2005Article
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Authors and funding
2 authors.
Funding
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Abstract
backgroundClinical practice guidelines (CPG) are thought to be an effective tool in improving efficiency and outcomes of clinical practice. Physicians' adherence to guidelines is reported to be poor. We evaluated the relationship between generalizability of guidelines on hypertension and physicians' adherence to guidelines' recommendations for pharmacological treatment.
methodsWe used the Sixth Joint National Committee's (JNC VI) guidelines on hypertension to evaluate our hypothesis. We evaluated the evidence from controlled clinical trials on which the JNC VI bases its recommendation, and compared the population enrolled in those trials with the American hypertensive population. Data on this population came from the National Health and Nutritional Examination Survey III.
resultsTwenty-three percent of the NHANES population had a diagnosis of hypertension, 11% had hypertension requiring drug treatment according to the JNC VI. Only half of the population requiring treatment would have been enrolled in at least two trials. Rate of adherence to CPG was 69%. We found a weak association between generalizability and physicians' adherence to guidelines. Baseline risk was the major determinant of the decision to treat.
conclusionJNC VI guidelines may not be generalizable to their target population. We found a relatively poor adherence rate to these guidelines. Failing of completely taking into account the clinical characteristics of the patients may be partly responsible for this lack of adherence.
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