Improving the diagnosis of hypertension and assessment of vascular risk factors through a clinica; audit in Kuwait family practice

ABSTRACT

To determine whether family practitioners are aware of the criteria for diagnosis of hypertensive patients. To investigate, if it is possible to change their behaviour in the diagnosis of hypertension and to see, if they could adhere to the new guideline of Kuwait protocol. Design: Review of medical records in general practices to identify hypertensive patients followed up by assessment of the pre- and post-educational management of interventions. Setting: Two family practices [Hadiya and Yarmouk] in Kuwait were included from two major health areas. Subjects: Two hundred hypertensive patients managed by ten family practitioners were included in the study. Main Outcome Measures: Improved level of diagnosis and care in terms of having at least three blood pressure readings before the start of drug treatment; better level of recording of Ali A Al-Yahya1, Huda S Al-Duwaisan2, Amal M Al-Mehza3 Primary Health Care, Jaber Al Ali Clinic1, Yarmouk Clinic2, and Hadiya Clinic3, Kuwait risk factors of hypertension including age, gender, smoking history, family history of premature ischaemic heart disease, measurements of total serum cholesterol and glucose levels, and better control of blood pressure. Improvement was noted in the recordings of age, gender, total serum cholesterol and glucose levels in both family practices and family history of premature ischaemic heart disease and good control in one, [Yarmouk] although improvement in these parameters in addition to recording of smoking history was also noted in the second [Hadiya]. No improvement was noted in the correct diagnosis in either of the two. Clinical behaviour of family practitioners can be changed by peer review in terms of a better registration system. More complex behavioural changes, which require the cooperation of patients and cognitive actions by family practitioners need further investigation