INTRODUCTION: There is little information available on Therapeutic Inertia in Primary Care (PC). This study aimed to know the therapeutic behavior of the physician for uncontrolled hypertensive patients. PATIENTS AND METHODS: Cross-sectional, multicenter study that included hypertensive patients of both genders, under pharmacological treatment who were recruited consecutively in the PC out-patient clinic in all of Spain. Social-demographic, clinical and treatment data were recorded, as well as the motives for eventual therapeutic modification. Adequate BP control was considered when BP values were below 140/90 mmHg in general, and below 130/80 mmHg in diabetes, renal insufficiency or cardiovascular disease. RESULTS: A total of 10,520 patients (53.7% women) were included with average age of 64.6 (11.3 years). Of these, 44.4% the patients were receiving monotherapy and 55.6% were treated with combined therapy (two drugs 41.2%, three drugs 11.7%, and more than three 2.8%). Uncontrolled hypertension was found in 58.6% (95% CI. 57.6-59.5) of the patients. Treatment was modified by physicians in 30.4% (95% CI. 29.2-31.6) of the uncontrolled patients, combination with another drug being the most frequent behavior (46.3%), followed by dose increase (26.1%), and antihypertensive drug switch (22.8%). The perception of the physician of good BP control was the factor most associated with not modifying the treatment in uncontrolled patients. CONCLUSIONS: Study results showed that the PC physician modified antihypertensive treatment in only 3 out of 10 uncontrolled patients. When treatment modification was made, association of drugs was the most frequent behavior.
INTRODUCTION: There is little information available on Therapeutic Inertia in Primary Care (PC). This study aimed to know the therapeutic behavior of the physician for uncontrolled hypertensivepatients. PATIENTS AND METHODS: Cross-sectional, multicenter study that included hypertensivepatients of both genders, under pharmacological treatment who were recruited consecutively in the PC out-patient clinic in all of Spain. Social-demographic, clinical and treatment data were recorded, as well as the motives for eventual therapeutic modification. Adequate BP control was considered when BP values were below 140/90 mmHg in general, and below 130/80 mmHg in diabetes, renal insufficiency or cardiovascular disease. RESULTS: A total of 10,520 patients (53.7% women) were included with average age of 64.6 (11.3 years). Of these, 44.4% the patients were receiving monotherapy and 55.6% were treated with combined therapy (two drugs 41.2%, three drugs 11.7%, and more than three 2.8%). Uncontrolled hypertension was found in 58.6% (95% CI. 57.6-59.5) of the patients. Treatment was modified by physicians in 30.4% (95% CI. 29.2-31.6) of the uncontrolled patients, combination with another drug being the most frequent behavior (46.3%), followed by dose increase (26.1%), and antihypertensive drug switch (22.8%). The perception of the physician of good BP control was the factor most associated with not modifying the treatment in uncontrolled patients. CONCLUSIONS: Study results showed that the PC physician modified antihypertensive treatment in only 3 out of 10 uncontrolled patients. When treatment modification was made, association of drugs was the most frequent behavior.
Authors: Amy G Huebschmann; Trina Mizrahi; Alyssa Soenksen; Brenda L Beaty; Thomas D Denberg Journal: J Clin Hypertens (Greenwich) Date: 2012-03-16 Impact factor: 3.738
Authors: M J Martínez-Orozco; Z Perseguer-Torregrosa; V F Gil-Guillén; A Palazón-Bru; D Orozco-Beltran; C Carratalá-Munuera Journal: J Hum Hypertens Date: 2014-04-03 Impact factor: 3.012
Authors: Carlos Sanchis Doménech; José Luis Llisterri Caro; Vicente Palomo Sanz; Francisco Javier Alonso Moreno; Isidro López Rodríguez; Armando Nevado Loro; Miguel Ángel Zamorano; Natividad Gil García; M Dolores Aguilar Conesa; Pablo Lázaro Y de Mercado Journal: Aten Primaria Date: 2011-03-17 Impact factor: 1.137
Authors: José R Banegas; Krista Lundelin; Mariano de la Figuera; Juan J de la Cruz; Auxiliadora Graciani; Fernando Rodríguez-Artalejo; Juan García Puig Journal: PLoS One Date: 2011-09-14 Impact factor: 3.240