Use of anti-hypertensive medications: an educational need in Saudi primary health care

To describe the pattern of prescription of antihypertensive medications in Saudi primary health care, which might help in the identification of educational needs of practicing physicians. Cross-sectional study in PHC centers in Qatif, Saudi Arabia. Half of the adult hypertensives who were followed up [F/U] in 13 out of 26 PHC centers were selected, r and omly. Doctors from participating centers collected data from charts of 320 patients in regard to the use of antihypertensive medications. Patients on no medication, monotherapy and combination therapy were 6.6%, 65.4%, and 28%, respectively. Beta-blockers [BB], diuretics, angiotensin converting enzyme inhibitors [ACEI], calcium channel blockers [CCB] and methyldopa were used by 62.2%, 36.3%, 22.8%, 4.4% and 1.9%, respectively. Most of the CCB were short-acting [SA-CCB]. ACEIs were used in 33.8% of diabetic hypertensives. Half of the patients were on maximum or high-dose medications. This study shows evidence of many drawbacks in use of antihypertensive medications in PHC which m and ates consideration by the decision makers, practicing physicians, supervisory and educational bodies

role of primary health care centers in managing hypertension How far are they involved?

Primary health care [PHC] centers are proposed to play a major role in the provision of care for hypertensive patients. However little is known regarding the magnitude of service offered by PHC to hypertensives. The aim of this study is to see how far PHC centers are involved in terms of figures, in the management of hypertension. This was a retrospective [cohort] study in PHC centers in Qatif, Kingdom of Saudi Arabia. Half of the adult hypertensives that were followed up in 13 PHC centers were selected, randomly. This study was carried out during the month of September 2000. Records of 320 patients were reviewed; male: female 1.1:2.1; mean age +/- SD 55.8 +/- 12.4 years; diagnosed at a mean age of 49.6 +/- 11.9 years. Diabetes mellitus [DM] was diagnosed in 22.2% of the sample; 66% never smoked; 47.7% had positive family history of hypertension. The median number of visits to PHC was 6 visits in the last 6 months. Number of consultations of hypertensives to PHC physicians constituted 1.1-8.4% of the total consultations. Primary health care registers document 16-35.9% of the expected total number of adult hypertensives in the community. Hypertensives following up in PHC constitute 13.8% and 17% of the expected number of diagnosed male and female adult hypertensives in the community. The magnitude of service offered by PHC to diagnosed hypertensives is less than one fifth of the expected number of patients, and its load on general practitioners working in these centers is highly variable