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1.
Medicine (Baltimore) ; 93(27): e168, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25501059

ABSTRACT

To improve blood pressure (BP) control of their patients, physicians either adjust or switch antihypertensive medication. Currently, there is only limited information available on why physicians decide to switch antihypertensive medications. A questionnaire-based survey was performed between November 2011 and March 2012 in the Czech Republic. General practitioners were asked to fill in questionnaires about their hypertensive patients whose antihypertensive medication they were planning to change. These questionnaires recorded data about patient demographic information, cardiovascular risk factors, BP values, and reasons for switching antihypertensive medication. Two hundred eight-six general practitioners surveyed a total of 4341 hypertensive patients. The mean age of the patients was 59.8 years, 68.9% of patients were overweight or obese. Uncontrolled office systolic and diastolic BP >140/90 mm Hg was present in 89.6% and 81.5% of patients, respectively, despite the fact that 49.4% of patients used a combination of 2 or more antihypertensive drugs. The most common reasons for switching medication were insufficient BP control (73.7%), followed by aiming for a better 24-hour effect (38.4%) and increased cardiovascular risk of the patients (37.7%). The major reason for switching antihypertensive treatment in general practice was insufficient BP control. Switching medication because of adverse drug effects is less frequent than reported a decade ago.


Subject(s)
Antihypertensive Agents/administration & dosage , Drug Substitution/statistics & numerical data , Hypertension/drug therapy , Primary Health Care/statistics & numerical data , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Czech Republic , Female , Humans , Male , Middle Aged
2.
Stroke ; 39(6): 1844-9, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18436888

ABSTRACT

BACKGROUND AND PURPOSE: Stroke treatment is time-dependent, yet no study has systematically examined response to individual stroke symptoms in the general population. This nationwide study identifies which specific factors prompt correct response (calling 911) to stroke. METHODS: Between November and December of 2005, a survey using a 3-stage random-sampling method including area, household, and household member sampling was conducted throughout the Czech Republic. Participants >40 years old were personally interviewed via a structured and standardized questionnaire concerning general knowledge and correct response to stroke as assessed by the Stroke Action Test (STAT). Predictors of scoring >50% on STAT were identified by multiple regression. RESULTS: A total of 650 households were contacted, yielding 592 interviews (response rate 91%). Mean age was 58+/-12, 55% women. Sixty-nine percent thought stroke was serious condition, and 57% thought it could be treated. Also 54% correctly named >/=2 risk factors, and 46% named >/=2 warning signs. Eighteen percent of respondents scored >50% on STAT. The predictors of such a score were age (for each 10-year increment, OR 1.4, 95% CI 1.2 to 1.7), secondary school education (OR 1.7, 95% CI 1.1 to 2.6), knowing that stroke is a serious disease (OR 1.8, 95% CI 1.1 to 3.1), and knowing that stroke is treatable (OR 2.0, 95% CI 1.2 to 3.2). CONCLUSIONS: Knowledge about stroke in the Czech Republic was fair, yet response to warning signs was poor. Our study is the first to identify that calling 911 was influenced by knowledge that stroke is a serious and treatable disease and not by recognition of symptoms.


Subject(s)
Emergency Medical Service Communication Systems/statistics & numerical data , Emergency Medical Services/statistics & numerical data , Health Education/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Stroke/prevention & control , Stroke/therapy , Age Factors , Aged , Czech Republic , Educational Status , Emergency Medical Service Communication Systems/trends , Emergency Medical Services/trends , Female , Health Behavior , Health Education/trends , Health Knowledge, Attitudes, Practice , Health Surveys , Humans , Male , Middle Aged , Patient Education as Topic/statistics & numerical data , Patient Education as Topic/trends , Risk Factors , Stroke/nursing , Surveys and Questionnaires , Thrombolytic Therapy/psychology , Thrombolytic Therapy/trends
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