Hypertension management in primary health care : a survey in eight regions of Sweden
PURPOSE: To explore hypertension management in primary healthcare (PHC).
DESIGN: Structured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021.
SETTING: Seventy-six PHCCs in eight regions of Sweden.
MAIN OUTCOME MEASURES: Staffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up.
RESULTS: The management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in ≥96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300-11300) patients.
CONCLUSIONS: The management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
|---|---|
| Enthalten in: |
Scandinavian journal of primary health care - 41(2023), 3 vom: 12. Sept., Seite 343-350 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hellgren, Mikko [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Blood pressure |
|---|
| Anmerkungen: |
Date Completed 04.09.2023 Date Revised 07.09.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1080/02813432.2023.2242711 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM360607241 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM360607241 | ||
| 003 | DE-627 | ||
| 005 | 20231226083351.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/02813432.2023.2242711 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1201.xml |
| 035 | |a (DE-627)NLM360607241 | ||
| 035 | |a (NLM)37561134 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hellgren, Mikko |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hypertension management in primary health care |b a survey in eight regions of Sweden |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.09.2023 | ||
| 500 | |a Date Revised 07.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: To explore hypertension management in primary healthcare (PHC) | ||
| 520 | |a DESIGN: Structured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021 | ||
| 520 | |a SETTING: Seventy-six PHCCs in eight regions of Sweden | ||
| 520 | |a MAIN OUTCOME MEASURES: Staffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up | ||
| 520 | |a RESULTS: The management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in ≥96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300-11300) patients | ||
| 520 | |a CONCLUSIONS: The management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Blood pressure | |
| 650 | 4 | |a general practice | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a lifestyle factors | |
| 650 | 4 | |a primary health care | |
| 700 | 1 | |a Wennberg, Patrik |e verfasserin |4 aut | |
| 700 | 1 | |a Hedin, Katarina |e verfasserin |4 aut | |
| 700 | 1 | |a Jansson, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Nilsson, Staffan |e verfasserin |4 aut | |
| 700 | 1 | |a Nilsson, Gunnar |e verfasserin |4 aut | |
| 700 | 1 | |a Wändell, Per |e verfasserin |4 aut | |
| 700 | 1 | |a Bengtsson Boström, Kristina |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Scandinavian journal of primary health care |d 1993 |g 41(2023), 3 vom: 12. Sept., Seite 343-350 |w (DE-627)NLM013266128 |x 1502-7724 |7 nnns |
| 773 | 1 | 8 | |g volume:41 |g year:2023 |g number:3 |g day:12 |g month:09 |g pages:343-350 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/02813432.2023.2242711 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 41 |j 2023 |e 3 |b 12 |c 09 |h 343-350 | ||