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How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care
BACKGROUND: It 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. METHODS: Eighteen General Practitione...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883478/ https://www.ncbi.nlm.nih.gov/pubmed/24330411 http://dx.doi.org/10.1186/1471-2296-14-192 |
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author | Filippi, Alessandro Sangiorgi, Diego Buda, Stefano Esposti, Luca Degli Nati, Giulio Paolini, Italo Di Guardo, Antonino |
author_facet | Filippi, Alessandro Sangiorgi, Diego Buda, Stefano Esposti, Luca Degli Nati, Giulio Paolini, Italo Di Guardo, Antonino |
author_sort | Filippi, Alessandro |
collection | PubMed |
description | BACKGROUND: It 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. METHODS: Eighteen 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. RESULTS: The 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). CONCLUSIONS: Almost 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. |
format | Online Article Text |
id | pubmed-3883478 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38834782014-01-08 How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care Filippi, Alessandro Sangiorgi, Diego Buda, Stefano Esposti, Luca Degli Nati, Giulio Paolini, Italo Di Guardo, Antonino BMC Fam Pract Research Article BACKGROUND: It 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. METHODS: Eighteen 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. RESULTS: The 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). CONCLUSIONS: Almost 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. BioMed Central 2013-12-13 /pmc/articles/PMC3883478/ /pubmed/24330411 http://dx.doi.org/10.1186/1471-2296-14-192 Text en Copyright © 2013 Filippi et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Filippi, Alessandro Sangiorgi, Diego Buda, Stefano Esposti, Luca Degli Nati, Giulio Paolini, Italo Di Guardo, Antonino How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
title | How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
title_full | How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
title_fullStr | How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
title_full_unstemmed | How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
title_short | How many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
title_sort | how many hypertensive patients can be controlled in “real life”: an improvement strategy in primary care |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883478/ https://www.ncbi.nlm.nih.gov/pubmed/24330411 http://dx.doi.org/10.1186/1471-2296-14-192 |
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