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KMID : 0648320100160010043
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Journal of The Korean Society of Hypertension
2010 Volume.16 No. 1 p.43 ~ p.50
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Gap between guideline and real primary practice : treatment in patients with hypertension
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Lee Kwang-No
Park Chang-Gyu
Choi Cheol-Ung
Lim Hong-Euy
Kim Eung-Ju
Rha Seung-Woon
Seo Hong-Seog
Oh Dong-Joo
Park Jeong-Bae
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Abstract
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Background : In this study, we investigated the gap between treatment guidelines for hypertension and the actual treatment attitude of patients and doctors in actual practice.
Methods : Participants in this study were 100 primary care physicians and 200 hypertensive patients. We used a questionnaire that included baseline characteristics about monitoring blood pressure, medical treatment and lifestyle modification, and analysis based on the ‘2004 Korean Hypertension Guidelines’.
Results : There were four deviations from the guidelines. First, fewer than 30% of physicians followed the guidelines for blood pressure measurement. Second, 34% patients responded that they were not informed of the target blood pressure by their physician. Among the informed patients, 20% did not remember the target blood pressure. Third, there was a difference between physician and patient regarding recognition of drug compliance. Most patients recognized that they were compliant with their medicine dosage but only 30% of physicians did, nor did the physicians recognize that in 30% of patients blood pressure was not controlled because of poor compliance. Fourth, 90% of patients at the initial diagnosis received information regarding lifestyle modification. But it was just a recommendation and not a prescription.
Conclusions : There are significant gaps between treatment guidelines for hypertension and actual treatment status in actual primary practice. A better understanding of the guidelines is needed to improve this implementation gap.
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KEYWORD
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Hypertension, Guideline, Implementation gap, Primary care
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