Document Detail


Competence of general practitioners in giving advice about changes in lifestyle to hypertensive patients.
MedLine Citation:
PMID:  18936294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to assess the advice about lifestyle changes that general practitioners (GPs) gave hypertensive patients with different levels of cardiovascular risk. DESIGN: and METHODS: A stratified sample of primary health care physicians in Poland completed a questionnaire consisting of 8 case vignettes that differed with regard to 3 major variables: 1) the level of blood pressure (high-normal blood pressure or grade 2 hypertension), 2) the presence of selected risk factors such as smoking and obesity, and 3) diabetes mellitus. The case vignettes were followed by a series of open questions. RESULTS: The response rate was 65% (125/192 selected physicians responded). The mean age was 45.2 +/- 8.1 years, and the average length of professional experience in primary care was 14.7 +/- 9.3 years. For 1000 potential clinical decisions considered, all expected pieces of advice were given in 18.3% of situations, whereas in 11.5%, no advice concerning nonpharmacological treatment was provided. In 70.2% of situations, Polish primary health physicians gave incomplete advice. The average percentage of expected advice in all cases was 57.2% +/- 30.8%. The presence of hypertension along with other risk factors of cardiovascular disease was associated with better quality advice (P < 0.001), but the coexistence of diabetes mellitus had opposite consequences (P<0.001). CONCLUSIONS: Despite the existence of well-known guidelines for the treatment of hypertension in Poland, GPs rarely give complete lifestyle advice, particularly for patients with cardiovascular risk due to high-normal blood pressure and diabetes.
Authors:
Adam Windak; Barbara Gryglewska; Tomasz Tomasik; Krzysztof Narkiewicz; Tomasz Grodzicki
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-20
Journal Detail:
Title:  Medical decision making : an international journal of the Society for Medical Decision Making     Volume:  29     ISSN:  0272-989X     ISO Abbreviation:  Med Decis Making     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109073     Medline TA:  Med Decis Making     Country:  United States    
Other Details:
Languages:  eng     Pagination:  217-23     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland. mmwindak@cyf-kr.edu.pl
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Clinical Competence*
Communication*
Diabetes Mellitus
Female
Humans
Hypertension / therapy*
Male
Middle Aged
Physicians, Family*
Poland
Risk Factors
Risk Reduction Behavior*
Smoking Cessation
Weight Loss

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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