Mansoor Ali Ridhab, Abed Anas, Alqudah Abdelrahim, Alsayed Ahmad R
Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan.
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan.
Patient Prefer Adherence. 2025 May 7;19:1317-1335. doi: 10.2147/PPA.S510908. eCollection 2025.
This study aimed to assess the medical care strategies for primary Hypertension in Iraqi adults through a hospital-based problem-oriented plan to improve patient outcomes by identifying and addressing medical problems.
This cross-sectional study was conducted in a hospital setting of Iraqi adults diagnosed with primary hypertension. Data collection involved patient interviews, medical record reviews, and measurements of blood pressure (BP). The assessment of medical problem-oriented plans (MPOPs) was performed using the validated Alsayed_v1 tool, which includes three main components: the assessment of treatments, the MPOP classification system, and the care plan.
The study participants of 80 Iraqi patients had a mean age of 52.3 years, with 55% male and 45% female. Common comorbid conditions included diabetes mellitus (40%), chronic kidney disease (30%), and coronary artery disease (20%). The most commonly prescribed antihypertensive medications were angiotensin-converting enzyme inhibitors (ACEI) (75.00%). On average, participants were taking 2.087 antihypertensive medications (SD = 0.60), with the majority (63.75%) using a combination of two medications. However, the average BP among participants was 148/92 mmHg, indicating uncontrolled hypertension in most cases (90%). The study identified an average of 3.2 MPOPs per patient, with the most common being inappropriate drug selection (25%), incorrect dosage regimen (20%), and non-adherence to treatment (15%). The chi-squared analysis revealed a significant association between gender and blood pressure status (Χ² = 4.366, p = 0.037). Additionally, the study identified 233 MPOPs across four categories: Indication (23.18%), Effectiveness (53%), Safety (7%), and Patient-related issues (17%). A multiple regression analysis was performed to identify predictors of the number of MPOPs with which heart failure was a significant predictor (β = 4.931, p = 0.003).
The findings highlight the complexity of managing hypertension in Iraqi adults and underscore the need for personalized treatment plans to address the medical problems. Implementing a problem-oriented approach in clinical practice can lead to better BP control and improved health outcomes. This study provides valuable insights for healthcare providers and policymakers to enhance hypertension management strategies in Iraq. However, the study's findings should be interpreted with caution due to limitations such as a relatively small and specific sample, reliance on self-reported data, and the cross-sectional design, which restricts causal inference.
本研究旨在通过一项基于医院的以问题为导向的计划，评估伊拉克成年人原发性高血压的医疗护理策略，以通过识别和解决医疗问题来改善患者预后。
这项横断面研究在一家诊断为原发性高血压的伊拉克成年人医院环境中进行。数据收集包括患者访谈、病历审查和血压（BP）测量。使用经过验证的Alsayed_v1工具对以医疗问题为导向的计划（MPOPs）进行评估，该工具包括三个主要组成部分：治疗评估、MPOP分类系统和护理计划。
80名伊拉克患者的研究参与者平均年龄为52.3岁，男性占55%，女性占45%。常见的合并症包括糖尿病（40%）、慢性肾脏病（30%）和冠状动脉疾病（20%）。最常用的降压药物是血管紧张素转换酶抑制剂（ACEI）（75.00%）。参与者平均服用2.087种降压药物（标准差=0.60），大多数（63.75%）使用两种药物联合使用。然而，参与者的平均血压为148/92 mmHg，表明在大多数情况下（90%）高血压未得到控制。该研究发现每位患者平均有3.2个MPOPs，最常见的是药物选择不当（25%）、剂量方案不正确（20%）和不坚持治疗（15%）。卡方分析显示性别与血压状态之间存在显著关联（Χ² = 4.366，p = 0.037）。此外，该研究在四个类别中确定了233个MPOPs：适应证（23.18%）、有效性（53%）、安全性（7%）和患者相关问题（17%）。进行了多元回归分析以确定MPOPs数量的预测因素，其中心力衰竭是一个显著的预测因素（β = 4.931，p = 0.003）。
研究结果突出了伊拉克成年人高血压管理的复杂性，并强调了制定个性化治疗计划以解决医疗问题的必要性。在临床实践中实施以问题为导向的方法可以导致更好的血压控制和改善健康结果。本研究为医疗保健提供者和政策制定者加强伊拉克的高血压管理策略提供了有价值的见解。然而，由于样本相对较小且特定、依赖自我报告数据以及横断面设计限制了因果推断等局限性，该研究结果应谨慎解释。
