Myanganbayar Maral, Baatarsuren Uurtsaikh, Chen Guanmin, Bosurgi Roberta, So Geoffrey, Campbell Norm R C, Erdenebileg Nasantogtokh, Ganbaatar Khulan, Magsarjav Purevjargal, Batsukh Manduukhai, Munkherdene Tsatsralgerel, Unurjargal Tsolmon, Dashtseren Myagmartseren, Tserengombo Namkhaidorj, Batsukh Batbold, Bungert Andreas, Dashdorj Naranbaatar, Dashdorj Naranjargal
Onom Foundation, Onom Foundation Central Office, Ulaanbaatar, Mongolia.
Research Facilitation, Analytics, Alberta Health Services, Foothills Medical Centre, Calgary, AB, Canada.
J Clin Hypertens (Greenwich). 2018 Jun 12;20(8):1187-92. doi: 10.1111/jch.13320.
We examined the knowledge, attitudes, and practices of primary care doctors in Ulaanbaatar, Mongolia using a recently developed World Hypertension League survey. The survey was administered as part of a quality assurance initiative to enhance hypertension control. A total of 577 surveys were distributed and 467 were completed (81% response rate). The respondents had an average age of 35 years and 90.1% were female. Knowledge of hypertension epidemiology was low (13.5% of questions answered correctly); 31% of clinical practice questions had correct answers and confidence in performing specific tasks to improve hypertension control had 63.2% "desirable/correct" answers. Primary care doctors mostly had a positive attitude toward hypertension management (76.5% desirable/correct answers) and highly prioritized hypertension management activities (85.7% desirable/correct answers). Some important highlights included the majority (> 80%) overestimating hypertension awareness, treatment, and control rates; 78.2% used aneroid blood pressure manometers; 15% systematically screened adults for hypertension in their clinics; 21.8% reported 2 or more drugs were required to control hypertension in most people; and 16.1% reported most people could be controlled by lifestyle changes alone. 55% of respondents were not comfortable prescribing more than 1 or 2 antihypertensive drugs in a patient and the percentage of desirable/correct responses to treating various high-risk patients was low. Most (53%-74%) supported task shifting to nonphysician health care providers except for drug prescribing, which only 13.9% supported. A hypertension clinical education program is currently being designed based on the specific needs identified in the survey.
我们使用最近开发的世界高血压联盟调查问卷,对蒙古国乌兰巴托的基层医疗医生的知识、态度和实践进行了调查。该调查是作为一项旨在加强高血压控制的质量保证举措的一部分进行的。共发放了577份调查问卷,完成了467份(回复率81%)。受访者的平均年龄为35岁,90.1%为女性。高血压流行病学知识水平较低(正确回答问题的比例为13.5%);31%的临床实践问题回答正确,对执行改善高血压控制的特定任务的信心方面,“理想/正确”答案的比例为63.2%。基层医疗医生大多对高血压管理持积极态度(“理想/正确”答案的比例为76.5%),并高度重视高血压管理活动(“理想/正确”答案的比例为85.7%)。一些重要的亮点包括:大多数人(>80%)高估了高血压知晓率、治疗率和控制率;78.2%使用无液血压计;15%在其诊所对成年人进行高血压系统筛查;21.8%报告大多数人需要2种或更多药物来控制高血压;16.1%报告大多数人仅通过生活方式改变就能得到控制。55%的受访者对给患者开具超过1或2种抗高血压药物感到不自在,对治疗各类高危患者的“理想/正确”回答比例较低。除了药物处方(只有13.9%的人支持)外,大多数人(53%-74%)支持将任务转移给非医生医疗服务提供者。目前正在根据调查中确定的具体需求设计一项高血压临床教育计划。