Strasser T
J Hum Hypertens. 1996 Feb;10 Suppl 1:S27-8.
The categorical term "auditing" hypertension control is chosen on purpose, to emphasize the responsibility of health politicians for assessing the quality and effects of interventions in populations. Auditing of hypertension is needed for reasons of Efficacy, Economics and Ethics. An analysis of efficacy should test whether the local strategies of hypertension control are sufficiently adapted to the needs and characteristics of a given population. Economic analyses should consider hypertension control in the perspective of resources and priorities. The ethical imperative requires an assessment and follow-up of the effects of health measures on the population, by the same token as evaluation of treatment results is obligatory in clinical medicine. The WHO/WHL Hypertension Management Audit Project was an attempt to analyze the repercussions of hypertension control programs on selected population. Five approaches were taken: (i) assessment of the epidemiological situation; (ii) clinical analysis on a sample of patients; (iii) assessment of patient satisfaction and of (iv) physicians' knowledge and attitudes; and (v) drug utilization studies. The results showed (a) a mixture of under- and overdiagnosis of hypertension in populations; (b) undertreatment of various degrees; (c) mixed patient satisfaction; (d) partial compliance of physicians' concepts and attitudes with standards promulgated by WHO and ISH; and, (e) great differences (at the time of the study) between drug utilization patterns in different countries.
选用“审核”高血压控制这一分类术语是有意为之，目的是强调卫生政策制定者在评估针对人群的干预措施的质量和效果方面的责任。出于疗效、经济和伦理方面的原因，需要对高血压进行审核。疗效分析应检验当地的高血压控制策略是否充分适应特定人群的需求和特点。经济分析应从资源和优先事项的角度考虑高血压控制问题。伦理要求规定，与临床医学中对治疗结果进行评估一样，必须对卫生措施对人群的影响进行评估和跟踪。世界卫生组织/世界高血压联盟高血压管理审核项目旨在分析高血压控制项目对选定人群的影响。采取了五种方法：（一）评估流行病学情况；（二）对患者样本进行临床分析；（三）评估患者满意度以及（四）医生的知识和态度；（五）药物利用研究。结果显示：（一）人群中高血压存在诊断不足和过度诊断的情况；（二）存在不同程度的治疗不足；（三）患者满意度不一；（四）医生的观念和态度部分符合世界卫生组织和国际高血压学会颁布的标准；以及（五）（在研究时）不同国家的药物利用模式存在很大差异。
