School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong, Hong Kong Special Administrative Region, China.
School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China.
PLoS One. 2018 Oct 9;13(10):e0205529. doi: 10.1371/journal.pone.0205529. eCollection 2018.
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.
We aimed to evaluate the level of PCPs' adoption of the RF-HT and the potential barriers of its use in family practice.
A cross-sectional study was conducted by a self-administered validated survey among all PCPs in Hong Kong through various means.
We assessed the level of and factors associated with its adoption by multivariate logistic regression modelling.
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.
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.
自 2010 年以来，香港政府发布了《基层医疗成人高血压护理参考框架》（以下简称“RF-HT”）。自发布以来，尚无研究评估其在基层医疗医生（PCP）中的采用情况。
我们旨在评估 PCP 采用 RF-HT 的水平及其在家庭实践中使用的潜在障碍。
通过各种方式向香港所有 PCP 进行了一项横断面研究，通过自我管理的验证性调查进行。
我们通过多元逻辑回归模型评估了其采用水平及其相关因素。
在 2014-2015 年期间，共向 2297 名 PCP 发送了 3857 次邀请。我们收到了 383 份完成的问卷。采用的平均得分为 4.00 中的 3.43，47.5%的 PCP 在日常咨询中高度采用 RF-HT。男性从业者（调整后的优势比[OR] = 0.524，95%置信区间[CI] = 0.290-0.948，p = 0.033）和公共部门的 PCP（OR = 0.524，95%CI = 0.292-0.940，p = 0.030）采用 RF-HT 的可能性明显较低。完成培训或成为学术研究员的 PCP 比“未完成基本培训”（OR = 0.479，95%CI = 0.269-0.853，p = 0.012）或“更高水平的学员”（OR = 0.302，95%CI = 0.093-0.979，p = 0.046）更有可能采用 RF-HT。对 RF-HT 改进的三个最支持的建议是简化 RF-HT、提供袖珍版和促进患者使用。
在接受调查的 PCP 中，RF-HT 的采用水平较高。这些发现还强调了一些与采用相关的因素，这些因素可以为加强其在临床实践中的使用提供有针对性的干预措施。
