Parker A, Nagar B, Thomas G, Badri M, Ntusi N B A
Department of Medicine, University of Cape Town, South Africa.
Cardiovasc J Afr. 2011 Jul-Aug;22(4):186-90. doi: 10.5830/CVJA-2010-066.
Patient- and physician-related factors impact on the management and control of hypertension.
To systematically examine: (1) South African primary care doctors' state of knowledge on the management of hypertension; (2) primary health practitioners' knowledge on the South African hypertension guidelines; (3) current approaches to management of hypertensive patients; and (4) challenges to effective management of hypertension at primary level.
A cross-sectional, observational study using a semi-structured questionnaire was carried out in two large community health centres (CHCs) in the Cape Town metropole. All 16 doctors employed at both CHCs were voluntarily enrolled, seven (43.7%) of whom were female, with 14 (87.5%) younger than 40 years of age. The majority (81.2%) of the doctors surveyed had been practicing for less than 10 years.
Ten (62.5%) of the doctors surveyed aimed to treat hypertension to target, and recommendations on lifestyle modifications were reportedly poorly done. While 11 (68.8%) of the doctors were aware of the South African hypertension guidelines, were (81.8%) of them were not conversant with the contents thereof. Doctors estimated that only 35% of their patients are treated to target. Poor patient adherence to prescribed treatment, language difficulty, heavy patient load, medical staff shortages, and patient loss to follow up were identified by the doctors as significant impediments to the effective management of hypertension at the primary level of care.
Primary healthcare practitioners' knowledge regarding hypertension and the South African hypertension guidelines is poor. Management of hypertension by these doctors is sub-optimal. There are significant challenges to effective management of hypertension at this level of care.
患者及医生相关因素会影响高血压的管理与控制。
系统研究：（1）南非基层医疗医生对高血压管理的知识水平；（2）基层医疗从业者对南非高血压指南的了解；（3）当前高血压患者的管理方法；（4）基层有效管理高血压面临的挑战。
在开普敦大都市的两家大型社区卫生中心开展了一项横断面观察性研究，采用半结构化问卷。两家社区卫生中心聘用的所有16名医生自愿参与，其中7名（43.7%）为女性，14名（87.5%）年龄小于40岁。接受调查的医生中，大多数（81.2%）从业时间不到10年。
接受调查的医生中有10名（62.5%）旨在将高血压治疗至目标水平，据报道，关于生活方式改变的建议做得很差。虽然11名（68.8%）医生知晓南非高血压指南，但其中81.8%不熟悉其内容。医生估计他们的患者中只有35%得到了达标治疗。医生们认为患者对规定治疗的依从性差、语言障碍、患者负担过重、医务人员短缺以及患者失访是基层医疗有效管理高血压的重大障碍。
基层医疗从业者对高血压及南非高血压指南的了解较差。这些医生对高血压的管理并不理想。在这一医疗水平上，有效管理高血压面临重大挑战。
