Conducta del médico de atención primaria ante el mal control de la hipertensión arterial. Estudio PRESCAP 2010 / Medical conduct in Primary Care as regards blood pressure control. PRESCAP 2010 Study
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.)
; 39(1): 3-11, ene.-feb. 2013.
Article
in Spanish
| IBECS
| ID: ibc-109163
Responsible library:
ES1.1
Localization: BNCS
RESUMEN
Introducción. Es necesario tener mayor información sobre la inercia terapéutica en la hipertensión arterial (HTA). El objetivo de este estudio fue conocer la conducta del médico de atención primaria (AP) en pacientes hipertensos que presentan mal control de presión arterial (PA) y determinar los factores asociados. Pacientes y métodos. Estudio transversal y multicéntrico realizado en hipertensos asistidos en el ámbito de la AP española. Se registraron datos de los pacientes (sociodemográficos, clínicos y tratamiento) y médicos (asistenciales, formativos y conducta ante el mal control de PA). Se consideró mal control cuando el promedio de PA era >= 140/90mmHg. Resultados. Se incluyeron 12.961 hipertensos (52,0% mujeres), con una edad media de 66,3 (11,4) años y antigüedad media de la HTA de 9,1 (6,7) años. El 62,4% recibía terapia combinada (44,2%, 2 fármacos, y 18,2%, 3 o más). El 38,9% (IC 95% 38,1-39,7) presentó mal control de PA. El médico modificó el tratamiento en el 41,8% (IC 95% 40,4-43,2) de los 5.036 pacientes mal controlados. La conducta terapéutica más frecuente fue la asociación farmacológica (55,6%). La percepción por parte del médico de buen control de PA en el hipertenso mal controlado y la presencia de terapia combinada fueron las variables que mostraron mayor probabilidad de no modificar el tratamiento farmacológico. Conclusiones. El médico de AP modifica el tratamiento antihipertensivo en tan solo 4 de cada 10 hipertensos mal controlados. La percepción por parte del médico de buen control de PA es la variable que más incrementa la probabilidad de no modificar el tratamiento farmacológico (AU)
ABSTRACT
Introduction. There is a need for more information on therapeutic inertia in blood pressure (BP) treatment. The purpose of this study was to determine the therapeutic behaviour and associated factors of Primary Care (PC) physicians on uncontrolled hypertensive patients. Patients and methods. Cross-sectional multicentre study of patients with hypertension attending Spanish PC centres. Data was collected from patients (social-demographics, clinical status and treatment), as well as data from physicians (medical practice, background and therapeutic behaviour) were collected. Uncontrolled BP was considered when average BP values where >=140/90mmHg. Results. A total of 12,961 patients (52.0% women) were included. The mean age was 66.3 (SD 11.4) years, and mean number of years from diagnosis of hypertension was 9.1 (6.7) years. Almost two-thirds (62.4%) of the patients were taking a combined blood pressure treatment, (44.2% with two drugs and 18.2% with three drugs, or more). An uncontrolled BP was observed in 38.9% (95% CI 38.1-39.7) of patients. Treatment was changed by physicians in 41.8% (95% CI 40.4-43.2) out of 5,036 uncontrolled patients. Adding another drug was the most frequent behaviour (55.6%). The physician's perception of good BP control in uncontrolled patients, together with the presence of combined blood pressure treatment, were the two variables most strongly associated with therapeutic inertia. Conclusions. The Spanish PC Physician modified antihypertensive treatment in only 4 out of 10 uncontrolled patients. The physician's perception of good BP control was the variable most strongly associated with therapeutic inertia (AU)
Search on Google
Collection:
National databases
/
Spain
Health context:
SDG3 - Target 3.8 Achieve universal access to health
/
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Delivery Arrangements
/
Goal 9: Noncommunicable diseases and mental health
/
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
IBECS
Main subject:
Primary Health Care
/
Ethics, Professional
/
Hypertension
/
Malpractice
Type of study:
Controlled clinical trial
/
Etiology study
/
Health technology assessment
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
Spanish
Journal:
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.)
Year:
2013
Document type:
Article
Institution/Affiliation country:
Almirall/España
/
Centro de Salud Azuqueca de Henares/España
/
Centro de Salud Huerta del Rey/España
/
Centro de Salud Ingeniero Joaquín Benlloch/España
/
Centro de Salud Sillería/España
/
Centro de Salud de Casas Ibáñez/España
/
Centro de Salud de La Puebla de Montalbán/España
/
Centro de Salud de Vallobín-La Florida/España
/
Hospital Ramón y Cajal/España
/
Universidad Autónoma de Madrid/España