Psychiatry and Behavioral Sciences and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Carroll); Department of Pediatrics, Northwestern University Feinberg School of Medicine and AllianceChicago, Chicago, Illinois (Dr Mohanty); University of Utah College of Nursing, Salt Lake City (Dr Wallace); Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Langman); and Department of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City (Dr Smith).
Fam Community Health. 2023;46(2):123-127. doi: 10.1097/FCH.0000000000000358.
The purpose of this study was to contextualize the challenges of diagnosing and managing pediatric hypertension (pHTN) in federally qualified health centers. We conducted a survey among primary care clinicians (N = 72) who treat children (3-17 years old) in a national network of health centers. Clinicians reported practices of blood pressure (BP) measurement, barriers to diagnosis and management of pHTN, and use of population health tools. Most clinicians (83%) used electronic devices to measure BP, only 49% used manual BP readings for follow-up measurements, and more than half measured BP at each encounter. The highest-rated barrier to pHTN management was lack of comfort with antihypertensive medications (71% of respondents). Few clinicians (10%) had used population health tools, but most (78%) indicated they would like to use them for pHTN. These results offer clinician-level insights regarding implementation of the pHTN guideline in pediatric primary care settings.
本研究旨在从背景层面探讨在联邦合格健康中心诊断和管理儿科高血压(pHTN)的挑战。我们对参与全国性健康中心网络的基层医疗临床医生(N = 72)进行了一项调查。临床医生报告了血压(BP)测量实践、pHTN 诊断和管理的障碍,以及使用人群健康工具的情况。大多数临床医生(83%)使用电子设备测量 BP,只有 49%使用手动 BP 读数进行后续测量,超过一半的人每次就诊都测量 BP。管理 pHTN 的最高障碍是对降压药物的不适应(71%的受访者)。很少有临床医生(10%)使用过人群健康工具,但大多数(78%)表示他们希望将其用于 pHTN。这些结果为儿科初级保健环境中实施 pHTN 指南提供了临床医生层面的见解。