And How Often Do You Measure Blood Pressure?

DOI: 10.3238/zfa.2019.0419-0423

german translation / full article

Detmar Jobst, Susanne Niederhofer, Marie-Therese Puth, Markus Bleckwenn

Keywords: FM practice Hypertension blood pressure measurement test quality treatment quality

BackgroundOne third of hypertension patients in Germany are considered inadequately treated. Current guidelines recommend that blood pressure (BP) should be measured regularly to ensure good treatment quality. We were interested in how often individual control measurements take place in family physicians’ surgeries with treated hypertonic patients and what significance these controls might have.MethodsAn interventional and retrospective cross-sectional trial was conducted. In seven academic teaching practices at Bonn University, all hypertension patients who picked up a follow-up prescription for their antihypertensive medication were asked to take part in the study. After recruitment and written approval, blood pressure of each participant was determined as usual in practice and she/he was asked whether blood pressure medications were taken today. These data were recorded within 14 days in 2017. We compared these measurement results descriptively with each of these patients from the past 12 months.Results273 treated hypertensive patients participated, 137 of them were female. On average, two BP values (standard-deviation 1.7) were found in all practice media per year and patient, yet in 24.5 % of the cases not a single one. More than one third of the patients was hypertonic (140/90 mmHg or more) when measured once interventional. 62.0 % of all current readings were consistent with the previous mean blood pressure values. Specificity was 0.78, sensitivity 0.47. 89 out of 273 patients had not taken any medication on the day of the test (32.6 %) ConclusionsThe quality of treatment appears to need improvement. Since BP values are measured only infrequently, it is reasonable to assume that they cannot be documented adequately and that blood pressure therapies cannot be adequately controlled. Maybe, BP measurements at each follow-up prescription would lead to a better treatment quality (including questions regarding after the last tablet intake). This suggestion might be investigated.KeywordsHypertension; treatment quality; test quality; blood pressure measurement; FM practice

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