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1.
Artigo em Inglês | MEDLINE | ID: mdl-37372676

RESUMO

General practitioners (GPs) played a vital role during the COVID-19 pandemic. Little is known about GPs' view of their role, leadership, participation in regional services and preferences for future pandemic preparedness. This representative study of German GPs comprised a web-based survey and computer-assisted telephone interviewing (CATI). It addressed GPs' satisfaction with their role, self-perceived leadership (validated C-LEAD scale), participation in newly established health services, and preferences for future pandemic preparedness (net promotor score; NPS; range -100 to +100%). Statistical analyses were conducted using Spearman's correlation and Kruskal-Wallis tests. In total, 630 GPs completed the questionnaire and 102 GPs the CATI. In addition to their practice duties, most GPs (72.5%) participated in at least one regional health service, mainly vaccination centres/teams (52.7%). Self-perceived leadership was high with a C-LEAD score of 47.4 (max. 63; SD ± 8.5). Overall, 58.8% were not satisfied with their role which correlated with the feeling of being left alone (r = -0.349, p < 0.001). 77.5 % of respondents believed that political leaders underestimated GPs' potential contribution to pandemic control. Regarding regional pandemic services, GPs preferred COVID-19 focus practices (NPS +43.7) over diagnostic centres (NPS -31). Many GPs, though highly engaged regionally, were dissatisfied with their role but had clear preferences for future regional services. Future pandemic planning should integrate GPs' perspectives.


Assuntos
COVID-19 , Clínicos Gerais , Humanos , Pandemias , Liderança , COVID-19/epidemiologia , Serviços de Saúde , Atitude do Pessoal de Saúde
2.
Blood Press ; 32(1): 2165901, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-36637453

RESUMO

PURPOSE: Discrepancies exist between guideline recommendations and real-world practice of blood pressure (BP) measurements. The aim of this study was to assess, with a nationwide, questionnaire-based survey, the current practice of BP measurement and associated BP values in German medical practices. MATERIAL AND METHODS: A nationwide survey in German medical practices was performed in the period from 10 May 2021 to 15 August 2021. The questionnaire was divided into five sections. The current office BP (OBP) values as well as the current drug therapy were recorded. In addition, the implementation of office BP (OBP) and home BP monitoring (HBPM) was queried. For analysis, questionnaires were scanned and automatically digitised. RESULTS: A total of 7049 questionnaires were analysed, the majority of which came from general practitioners (66%) and internal medicine practices (34%). The average OBP (SD) was 140.0 (18)/82.7 (11) mmHg. 40.8% of treated patients had OBP in the controlled range, with monotherapy (34.7%) or dual combination therapy (38.2%) prescribed in most cases. OBP was taken from a single measurement in 66.3% of cases, and in 21.8% from 23 measurements. OBP was mostly measured after a rest period (87.1%) and in a separate room (80.4%). HBPM was performed in 62.3% of patients; however, in 24.9% of the participants HBP measurements were recorded once a week or less. CONCLUSION: In this nationwide survey in German medical practices, BP control remains at below 50%, while monotherapy is prescribed in around one third of patients. Moreover, office measurements and HBPM are often not performed according to current guideline recommendations.


What is the context?Elevated blood pressure (hypertension) is an important risk factor for diseases such as stroke or heart attack. However, sufficient drug therapy can significantly reduce the risk of complications such as a stroke. An adequate blood pressure measurement is the basis for diagnostics and successful therapy. In order to measure blood pressure as accurately as possible, recommendations for performing blood pressure measurements (at home as well as in the office) have been published by medical societies.Research suggests that blood pressure is not always measured according to these recommendations. However, there are no current studies for Germany.What is new?In this study, we analysed the results of a survey in which medical practices and pharmacies throughout Germany were asked about blood pressure measurement and blood pressure therapy. The key results of our study suggest that:• The blood pressure of many participants with known hypertension is not within the desired target range.• Office blood pressure measurements are often not performed as suggested by guidelines. This mainly affects time-consuming work steps such as repeating the measurement several times.• Home blood pressure is not recorded in a structured form, as suggested, but rather according to a random pattern by the patient. What is important?This study suggests that blood pressure control is not sufficient in the study participants. Furthermore, blood pressure measurement as an important tool for hypertension management is frequently not performed as proposed by guidelines.


Assuntos
Hipertensão , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Pressão Sanguínea , Determinação da Pressão Arterial , Monitorização Ambulatorial da Pressão Arterial , Alemanha , Inquéritos e Questionários
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