Hypertension management in primary health care : a survey in eight regions of Sweden
(2023) In Scandinavian Journal of Primary Health Care 41(3). p.343-350- Abstract
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... (More)
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.
(Less)
- author
- Hellgren, Mikko ; Wennberg, Patrik ; Hedin, Katarina LU ; Jansson, Stefan ; Nilsson, Staffan ; Nilsson, Gunnar ; Wändell, Per and Bengtsson Boström, Kristina
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Blood pressure, general practice, hypertension, lifestyle factors, primary health care
- in
- Scandinavian Journal of Primary Health Care
- volume
- 41
- issue
- 3
- pages
- 8 pages
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:37561134
- scopus:85167700443
- ISSN
- 0281-3432
- DOI
- 10.1080/02813432.2023.2242711
- language
- English
- LU publication?
- yes
- id
- 9fd255f1-7184-41a1-8568-b2f08d005b53
- date added to LUP
- 2023-12-01 13:21:03
- date last changed
- 2024-04-14 14:26:19
@article{9fd255f1-7184-41a1-8568-b2f08d005b53, abstract = {{<p>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.</p>}}, author = {{Hellgren, Mikko and Wennberg, Patrik and Hedin, Katarina and Jansson, Stefan and Nilsson, Staffan and Nilsson, Gunnar and Wändell, Per and Bengtsson Boström, Kristina}}, issn = {{0281-3432}}, keywords = {{Blood pressure; general practice; hypertension; lifestyle factors; primary health care}}, language = {{eng}}, number = {{3}}, pages = {{343--350}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Journal of Primary Health Care}}, title = {{Hypertension management in primary health care : a survey in eight regions of Sweden}}, url = {{http://dx.doi.org/10.1080/02813432.2023.2242711}}, doi = {{10.1080/02813432.2023.2242711}}, volume = {{41}}, year = {{2023}}, }