Arroll B, Jenkins S, North D
Department of General Practice, University of Auckland, New Zealand.
J Hypertens. 1996 Jun;14(6):773-7. doi: 10.1097/00004872-199606000-00014.
To describe the type and level of non-pharmacological management offered by general practitioners for essential hypertension.
An open-ended interviewer-administered survey using a standard case of a 60-year-old man with essential hypertension. Seventy interviews were conducted face-to-face and 30 by telephone.
Auckland general practices.
A random sample of 100 Auckland general practitioners.
Aspects of the medical histories of patients, physical examination, laboratory testing and treatment relevant to non-pharmacological management.
There was an 84% response rate. Most general practitioners reported offering non-pharmacological management at the first consultation before prescribing medication. However, few offered detailed programmes. Dietary therapy, restriction of alcohol consumption and exercise were suggested by most general practitioners. Restriction of sodium intake and behavioural therapy were less popular non-pharmacological interventions. The median number of visits of patients to a general practitioner before drugs were prescribed was five, which is in keeping with guidelines. The median number of days from the first visit to prescription of drug therapy was 42 (range 2-341). The clinical advice given by the majority of participants was consistent with current guidelines on the treatment of hypertension but the range of advice given was wide.
The results suggest that general practitioners are aware of non-pharmacological interventions for the management of hypertension. They report making routine use of non-pharmacological therapies for blood pressure reduction and other health benefits early in the clinical process before considering pharmacological therapy. These non-pharmacological therapies are not delivered with well-defined and detailed programmes.
描述全科医生对原发性高血压提供的非药物治疗的类型和水平。
采用一名60岁原发性高血压男性的标准病例进行开放式访谈者管理的调查。面对面进行了70次访谈，通过电话进行了30次访谈。
奥克兰的全科诊所。
从奥克兰的100名全科医生中随机抽取的样本。
与非药物治疗相关的患者病史、体格检查、实验室检查和治疗方面。
应答率为84%。大多数全科医生报告在开处方前的首次咨询时提供非药物治疗。然而，很少有人提供详细的方案。大多数全科医生建议进行饮食疗法、限制饮酒和运动。限制钠摄入和行为疗法是非药物治疗中较不受欢迎的干预措施。患者在开药物处方前看全科医生的就诊次数中位数为5次，这与指南一致。从首次就诊到开始药物治疗的天数中位数为42天（范围2 - 341天）。大多数参与者给出的临床建议与当前高血压治疗指南一致，但建议的范围很广。
结果表明，全科医生了解高血压管理的非药物干预措施。他们报告在考虑药物治疗之前，在临床过程早期常规使用非药物疗法来降低血压和获得其他健康益处。这些非药物疗法没有以明确和详细的方案提供。
