alexa Abstract | Factors that impact on the application of guidelines in general practice: a review of medical records and structured investigation of clinical incidents in hypertension

Quality in Primary Care
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Paper Open Access

Abstract

Introduction The management of hypertension in the older individual is complicated by the need to take into account the effect of the ageing process. However, older hypertensive patients are at higher risk of vascular disease, and therapy may be morecost-effective in this age group. Methods A retrospective review of case notes at two general practices serving over 19 000 patients in the UK. Patients were aged 75 years or older and treated for hypertension for at least one year at the time ofsurvey. The latest recorded blood pressure was used to identify patients who remained hypertensive despite drug treatment. Therapy prescribed, patient preferences recorded, investigations performed, scope for further therapy and documented plans for management were compared. In the second part the general practitioners were asked to explain why some patients were offered more medication than others.Results Three-hundred and twelve records were surveyed. Differences in the management of cases between the two practices were noted. One-hundred and nine patients were prescribed three or more classes of therapy. Asignificantly greater proportionof these cases were prescribed higher doses or additional therapy at their last consultation. Patients who were offered a more ‘active’ approach were thought to be better informed and better advocates for themselves.Discussion Overall the data suggest inconsistency in the management of a group with the same disorder. Contrary to expectations, patients who were already prescribed three or more antihypertensive agents were more likely at their most recent consultation to be offered even higher doses or additional drugs, than those on fewer agents. Subjective biases, faulty generalisations and lost opportunities for reviewing therapy may account for differences in the management of the same patient group. Further research into factors that influence the application of clinical guidelines with reference to the consultation in primary care is warranted.

To read the full article Peer-reviewed Article PDF image

Author(s): Michael Gordon Jennifer Freeman Claire Fisher Geoff Schrecker John Reid

Keywords

Innovative primary care, Primary care medicines, Advanced concepts in primary care

 
Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords