ArticleBMC family practice2013
How many hypertensive patients can be controlled in "real life": an improvement strategy in primary care.
Article in BMC family practice, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Immigration Emergency in Italy: The Impact of Socioeconomic Status on Blood Pressure Levels and Control.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2019Article
- The Pharmacogenomic and Metabolomic Predictors of ACE Inhibitor and Angiotensin II Receptor Blocker Effectiveness and Safety.Cardiovascular drugs and therapy · 2017Review
- Prevalence and control of hypertension in the general practice in Italy: updated analysis of a large database.Journal of human hypertension · 2017Article
- Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level.Arquivos brasileiros de cardiologia · 2017Article
- Prevalence and Control of Hypertension in Different Macro-Areas in Italy: Analysis of a Large Database by the General Practice.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2016Article
- High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55-64 Years in Holstebro County.American journal of hypertension · 2016Article
- [Evaluation of referral process of the hypertensive patient in Spain: DERIVA study].Atencion primaria · 2015Observational
- Why is my hypertensive patient still not controlled?High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2015Article
- Lack of blood pressure control in Italy: room for improvement?High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2015Article
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Authors and funding
8 authors.
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Abstract
backgroundIt is well known that hypertension control is non-satisfactory, but it is not clear how many hypertensive patients can be controlled in real life. We addressed this question implementing a simple, multifaceted improvement strategy in family practice.
methodsEighteen General Practitioner (GPs) agreed upon a simple improvement strategy including: 1) the use of occasional direct/indirect contacts (prescription refilling) to decrease missing blood pressure (BP) recording, and to increase therapeutic adherence, 2) the use of home BP measurements in non-controlled patients, 3) the addition of a new drug in non-controlled, but adequately adherent patients. Results were assessed after one year by automatic data extraction from the clinical records of all hypertensive subjects.
resultsThe patients with a diagnosis of hypertension increased from 6.309 (age 58.5 +/- 12.4; M 45.5%) to 6.717 (age 58.6 +/- 12.9; M 45.7%): prevalence 25.3% to 27.0%. The BP recording increased: 4,305 patients (68.2%) vs 4,948 patients (78.4%) (+ 10.2%, ci 9.4%-10.9%; p < 0.001), as well as the BP control: 3,203 (50.8% of all the diagnosed hypertensive patients and 74.4% of the subjects with recorded BP value) vs 4,043 (64.1% of all the diagnosed hypertensive patients and 81.7% of the subjects with recorded BP value) (+ 13.3%, ci 12.5%-14.2%; p < 0.001 and + 7.3%, ci 6.7%-8.0%; p < 0.001).
conclusionsAlmost 82% of hypertensive subjects who contact their doctors can be easily controlled. Most non-controlled patients simply don't see their GPs; in almost all the remaining non-controlled patients GPs fail to increase drug therapy. A further improvement is therefore possible.
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