Dataset Information

The adoption of hypertension reference framework: An investigation among primary care physicians of Hong Kong.

ABSTRACT:

Background

The Hong Kong Government released a Reference Framework (RF-HT) for Hypertension Care for Adults in Primary Care Settings since 2010. No studies have evaluated its adoption by primary care physicians (PCPs) since its release.

Aim

We aimed to evaluate the level of PCPs' adoption of the RF-HT and the potential barriers of its use in family practice.

Design and setting

A cross-sectional study was conducted by a self-administered validated survey among all PCPs in Hong Kong through various means.

Methods

We assessed the level of and factors associated with its adoption by multivariate logistic regression modelling.

Result

A total of 3,857 invitation episodes were sent to 2,297 PCPs in 2014-2015. We received 383 completed questionnaires. The average score of adoption was 3.43 out of 4.00, and 47.5% of PCPs highly adopted RF-HT in their daily consultations. Male practitioners (adjusted odds ratio [aOR] = 0.524, 95% CI = 0.290-0.948, p = 0.033) and PCPs of public sector (aOR = 0.524, 95% CI = 0.292-0.940, p = 0.030) were significantly less likely to adopt the RF-HT. PCPs with higher training completion or being academic fellow are more likely to adopt RF-HT than those who were "nil to basic training completion" (aOR = 0.479, 95% CI = 0.269-0.853, p = 0.012) or "higher trainee" (aOR = 0.302, 95% CI = 0.093-0.979, p = 0.046). Three most-supported suggestions on RF-HT improvement were simplification of RF-HT, provision of pocket version and promoting in patients.

Conclusion

Among PCP respondents, the adoption level of the RF-HT was high. These findings also highlighted some factors associated with its adoption that could inform targeted interventions for enhancing its use in clinical practice.

SUBMITTER: Fang Y

PROVIDER: S-EPMC6177174 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

The adoption of hypertension reference framework: An investigation among primary care physicians of Hong Kong.

Fang Yuan Y Wang Harry H X HHX Liang Miaoyin M Yeung Ming Sze MS Leung Colette C Chan Chun Hei CH Cheung Wilson W Huang Jason L W JLW Huang Junjie J Sit Regina W S RWS Wong Samuel Y S SYS Wong Martin C S MCS

PloS one 20181009 10

<h4>Background</h4>The Hong Kong Government released a Reference Framework (RF-HT) for Hypertension Care for Adults in Primary Care Settings since 2010. No studies have evaluated its adoption by primary care physicians (PCPs) since its release.<h4>Aim</h4>We aimed to evaluate the level of PCPs' adoption of the RF-HT and the potential barriers of its use in family practice.<h4>Design and setting</h4>A cross-sectional study was conducted by a self-administered validated survey among all PCPs in Ho ...[more]

PMID: 30300397

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Project description:BackgroundHypertension is strongly associated with cardiovascular events. Studies have shown that electrocardiographic (ECG) abnormalities were associated with increased risks for cardiovascular events. However local data is limited. The objectives of this study were: (1) to determine the prevalence of major electrocardiographic abnormalities in patients with hypertension in primary care in Hong Kong, and (2) to determine the association of major electrocardiographic abnormalities with patients' socio-economical background, cardiovascular disease and cardiovascular risk factors.MethodsThis was a cross-sectional study. Subjects were hypertensive patients aged between 18 and 80 who were enrolled in the Risk Assessment and Management Programme (RAMP) in a general outpatient clinic in Hong Kong. Outcome measures were prevalence of probable ischaemic heart disease (IHD), complete left bundle branch block (LBBB), left ventricular hypertrophy (LVH) and atrial fibrillation (AF) in patients with hypertension. The Pearson Chi-square test, independent t-test and Mantel-Haenszel test were used to measure the association between socioeconomic characteristics and cardiovascular risk factors, and ECG abnormalities.Results504 hypertensive patients aged 18-80 were recruited in a general outpatient clinic. 6.3% had probable IHD, 0.4% had complete LBBB, 4.0% had LVH and 1.0% had AF. Probable IHD was associated with smoking (P = 0.032), hypercholesterolaemia (P = 0.037) and higher 10-year CV risk (P = 0.04). Complete LBBB was associated with smoking (P = 0.021) and hypercholesterolaemia (P = 0.022). LVH was associated with male gender (P = 0.001) and longer duration of hypertension (P = 0.035). AF was not significantly associated with any of the clinical or sociodemographic parameters.ConclusionsThis study showed that a significant proportion of patients with hypertension at the primary care setting in Hong Kong had probable ischaemic heart disease, left ventricular hypertrophy and atrial fibrillation. This finding is consistent with both overseas data and historic data in Hong Kong. The detection of electrocardiographic abnormalities is helpful in hypertension management by improving risk stratification.

Project description:BackgroundUp-to-date and accurate information about the health problems encountered by primary care doctors is essential to understanding the morbidity pattern of the community to better inform health care policy and practice. Morbidity surveys of doctors allow documentation of actual consultations, reflecting the patient's reason for seeking care as well as the doctor's diagnostic interpretation of the illness and management approach. Such surveys are particularly critical in the absence of a centralized primary care electronic medical record database.ObjectiveWith the changing sociodemographic profile of the population and implementation of health care initiatives in the past 10 years, the aim of this study is to determine the morbidity and management patterns in Hong Kong primary care during a pandemic and compare the results with the last survey conducted in 2007-2008.MethodsThis will be a prospective, practice-based survey of Hong Kong primary care doctors. Participants will be recruited by convenience and targeted sampling from both public and private sectors. Participating doctors will record the health problems and corresponding management activities for consecutive patient encounters during one designated week in each season of the year. Coding of health problems will follow the International Classification of Primary Care, Second Edition. Descriptive statistics will be used to calculate the prevalence of health problems and diseases as well as the rates of management activities (referral, investigation, prescription, preventive care). Nonlinear mixed effects models will assess the differences between the private and public sectors as well as factors associated with morbidity and management patterns in primary care.ResultsThe data collection will last from March 1, 2021, to August 31, 2022. As of April 2022, 176 doctor-weeks of data have been collected.ConclusionsThe results will provide information about the health of the community and inform the planning and allocation of health care resources.Trial registrationClinicalTrials.gov NCT04736992; https://clinicaltrials.gov/ct2/show/NCT04736992.International registered report identifier (irrid)DERR1-10.2196/37334.

Dataset Information

The adoption of hypertension reference framework: An investigation among primary care physicians of Hong Kong.

Background

Aim

Design and setting

Methods

Result

Conclusion

Publications

The adoption of hypertension reference framework: An investigation among primary care physicians of Hong Kong.

Similar Datasets

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