Enrique Martín-Rioboó1,2, Luis A Pérula de Torres1,3, José R Banegas4, José M Lobos-Bejarano5, Carlos Brotons Cuixart6, Emilio I García Criado2, Pilar Martin-Carrillo7, María Martín-Rabadán Muro8, M Isabel Egocheaga Cabello9, Antoni Maiques Galán10. 1. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Reina Sofía/Universidad de Córdoba. 2. Fuensanta Primary Care Health Centre. 3. Cordoba Teaching Unit of Family Medicine, Distrito Sanitario Córdoba y Guadalquivir, Córdoba. 4. Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health (CIBERESP). 5. Jazmín Primary Care Health Centre, Área Este, Madrid. 6. Research Unit, Sardenya Primary Care Health Centre, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona. 7. Colmenarejo Primary Care Health Centre, Madrid. 8. Can Misses Primary Healthcare Centre, Ibiza. 9. Isla de Oza Primary Care Health Centre, Madrid. 10. Manises Primary Care Health Centre, Valencia, Spain.
Abstract
OBJECTIVE: To examine the degree of knowledge and management of automated devices for office blood pressure measurement (AD), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) in primary care in Spain. METHODS: Online self-administered survey sent between May 2016 and February 2017 to 2221 primary-care physicians working across Spain. Clinicians were mostly identified through national primary-care scientific societies (20% overall response rate). RESULTS: Participants' mean age was 47.7 years, 55% were women, and 54% reported at least 20 years of primary-care practice. Among them, 47.5% considered ABPM the best diagnostic method for hypertension, 23% chose HBPM, and 7.1% chose office blood pressure. Also, 78.2% had AD available at their centers and 49.0% had ABPM, with slight urban/rural differences. HBPM was recommended in daily practice for hypertension diagnosis by 67% of participants, whereas 30% recommended ABPM. Cost to the patients was the main reason for not using HBPM (42.7%) as was lack of accessibility for not using ABPM (69.8%). Lack of specific training was also reported as an important reason in both cases. CONCLUSION: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines' recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies.
OBJECTIVE: To examine the degree of knowledge and management of automated devices for office blood pressure measurement (AD), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) in primary care in Spain. METHODS: Online self-administered survey sent between May 2016 and February 2017 to 2221 primary-care physicians working across Spain. Clinicians were mostly identified through national primary-care scientific societies (20% overall response rate). RESULTS:Participants' mean age was 47.7 years, 55% were women, and 54% reported at least 20 years of primary-care practice. Among them, 47.5% considered ABPM the best diagnostic method for hypertension, 23% chose HBPM, and 7.1% chose office blood pressure. Also, 78.2% had AD available at their centers and 49.0% had ABPM, with slight urban/rural differences. HBPM was recommended in daily practice for hypertension diagnosis by 67% of participants, whereas 30% recommended ABPM. Cost to the patients was the main reason for not using HBPM (42.7%) as was lack of accessibility for not using ABPM (69.8%). Lack of specific training was also reported as an important reason in both cases. CONCLUSION: Even in the possibly best primary care scenario presented by highly motivated physicians (respondents to a voluntary anonymous survey), enormous gaps were observed between current guidelines' recommendations on ABPM and HBPM use for confirming hypertension and the modest degree of knowledge, availability, and use of these technologies.
Authors: Enrique Martín Rioboó; Jose Ramón Banegas; Luis Angel Pérula de Torres; Jose María Lobos Bejarano Journal: Aten Primaria Date: 2018-04-11 Impact factor: 1.137
Authors: Carlos Brotons Cuixart; José Juan Alemán Sánchez; José Ramón Banegas Banegas; Carlos Fondón León; José María Lobos-Bejarano; Enrique Martín Rioboó; Jorge Navarro Pérez; Domingo Orozco-Beltrán; Fernando Villar Álvarez Journal: Aten Primaria Date: 2018-05 Impact factor: 1.137