In:
Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 76, No. Suppl_1 ( 2020-09)
Abstract:
Context: The US Preventive Services Task Force recommends out-of-office blood pressure (BP) measurement before making a new diagnosis of hypertension, using 24-hour ambulatory (ABPM) or home BP monitoring. However, this approach is not common in routine practice. Objective: To evaluate provider knowledge, beliefs, and practices about BP diagnostic tests Methods: The setting was 10 primary care medical centers in a single health care system. E-mails with a link to a survey were sent to 420 providers, with 282 (67%) responding, including 102 medical assistants (MA), 28 licensed practical nurses (LPN), 33 registered nurses (RN), 86 primary care physicians (physician), and 33 advanced practitioners (AP). Outcomes were a descriptive analysis of provider BP measurement and hypertension diagnosis knowledge, beliefs, and practices. Results: Most providers (78.8%) believed that BP measured manually with a stethoscope and ABPM as very or highly accurate way to measure BP when making a new diagnosis of hypertension. In contrast, most providers did not believe that automated clinic BPs, home BP, or kiosk BP measurements were very or highly accurate. Almost all providers reported that they always or almost always relied on clinic BP measurements in making a new diagnosis of hypertension (95.7%), but the majority of physician/APs would prefer using ABPM (60.5%) if it was readily available. Providers were mixed as to whether patients received home BP training and whether home BP monitors were checked for accuracy. Physician/APs reported varying home BP schedules with no schedule the most common response (37.3%), followed by 14 days (19.1%), and 7 days (10.9%). Almost all physicians/APs reported using a clinic BP threshold of 140/90 mmHg for making a new diagnosis of, but a few reported 130/80 mmHg. Very few physician/APs reported guideline concordant home or ABPM diagnostic thresholds, with 140/90 mmHg the most common response. Conclusion: In our study providers did not report following evidence-based guidelines for making a new diagnosis of hypertension, and appeared to have substantial gaps in knowledge, beliefs, and use of recommended practices. Interventions to increase use of evidence-based practices for diagnosing hypertension are needed.
Type of Medium:
Online Resource
ISSN:
0194-911X
,
1524-4563
DOI:
10.1161/hyp.76.suppl_1.P163
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2094210-2
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