Physician factors associated with the blood pressure control among hypertensive patients

So Young Kim, In Sook Cho, Jae Ho Lee, Ji Hyun Kim, Eun Jung Lee, Jong Hyock Park, Jin-Seok Lee, Yoon Kim

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)

Abstract

Objectives: Little is known about the physician-related factors that are associated with the management of hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods: We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do. Forty-one physicians completed the survey (response rates: 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the selfreported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center's information system. We compared the physicians' perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians' antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physicianrelated factors. Results: The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients' control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensinconverting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI: 1.17-1.48). Conclusions: Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians' overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician' awareness regarding the management of patients with hypertension are needed.

Original languageEnglish
Pages (from-to)487-494
Number of pages8
JournalJournal of Preventive Medicine and Public Health
Volume40
Issue number6
DOIs
StatePublished - 1 Nov 2007

Fingerprint

Blood Pressure
Physicians
Hypertension
Prescriptions
Antihypertensive Agents
Diabetes Mellitus
Health Information Systems
Angiotensin Receptor Antagonists
Enzyme Inhibitors
Public Health
Logistic Models
Regression Analysis

Keywords

  • Hypertension
  • Hypertension control rate
  • Physician awareness

Cite this

Kim, So Young ; Cho, In Sook ; Lee, Jae Ho ; Kim, Ji Hyun ; Lee, Eun Jung ; Park, Jong Hyock ; Lee, Jin-Seok ; Kim, Yoon. / Physician factors associated with the blood pressure control among hypertensive patients. In: Journal of Preventive Medicine and Public Health. 2007 ; Vol. 40, No. 6. pp. 487-494.
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title = "Physician factors associated with the blood pressure control among hypertensive patients",
abstract = "Objectives: Little is known about the physician-related factors that are associated with the management of hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods: We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do. Forty-one physicians completed the survey (response rates: 26.6{\%}) and 31 physicians were finally included as the study subjects. Using the information obtained from the selfreported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center's information system. We compared the physicians' perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25{\%} of the median degree of hypertension control rate overestimation) among the physicians. The physicians' antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physicianrelated factors. Results: The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5{\%} perceived vs. 57.8{\%} actual). The percentage of physicians with high overestimation was 35.5{\%} (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients' control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensinconverting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95{\%} CI: 1.17-1.48). Conclusions: Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians' overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician' awareness regarding the management of patients with hypertension are needed.",
keywords = "Hypertension, Hypertension control rate, Physician awareness",
author = "Kim, {So Young} and Cho, {In Sook} and Lee, {Jae Ho} and Kim, {Ji Hyun} and Lee, {Eun Jung} and Park, {Jong Hyock} and Jin-Seok Lee and Yoon Kim",
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Physician factors associated with the blood pressure control among hypertensive patients. / Kim, So Young; Cho, In Sook; Lee, Jae Ho; Kim, Ji Hyun; Lee, Eun Jung; Park, Jong Hyock; Lee, Jin-Seok; Kim, Yoon.

In: Journal of Preventive Medicine and Public Health, Vol. 40, No. 6, 01.11.2007, p. 487-494.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Physician factors associated with the blood pressure control among hypertensive patients

AU - Kim, So Young

AU - Cho, In Sook

AU - Lee, Jae Ho

AU - Kim, Ji Hyun

AU - Lee, Eun Jung

AU - Park, Jong Hyock

AU - Lee, Jin-Seok

AU - Kim, Yoon

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N2 - Objectives: Little is known about the physician-related factors that are associated with the management of hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods: We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do. Forty-one physicians completed the survey (response rates: 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the selfreported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center's information system. We compared the physicians' perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians' antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physicianrelated factors. Results: The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients' control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensinconverting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI: 1.17-1.48). Conclusions: Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians' overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician' awareness regarding the management of patients with hypertension are needed.

AB - Objectives: Little is known about the physician-related factors that are associated with the management of hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods: We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do. Forty-one physicians completed the survey (response rates: 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the selfreported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center's information system. We compared the physicians' perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians' antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physicianrelated factors. Results: The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients' control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensinconverting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI: 1.17-1.48). Conclusions: Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians' overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician' awareness regarding the management of patients with hypertension are needed.

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