Knowledge and Adherence of Primary Health Care Physicians to Hypertension Management Guidelines in Family Health Facilities, Tanta Gharbia

Abstract

Background: Hypertension is a long-term condition in which the blood pressure in arteries is persistently elevated higher than 130 over 80 millimeters of mercury. Hypertension as an office systolic blood pressure and/or Diastolic Blood Pressure; which is equivalent to a 24-hours average ambulatory blood pressure management (AMBPM > 130/80 mmHg) or home blood pressure measurements (HBPM) average >135/85 mmHg. Aim: To assess knowledge of physicians in the family health facilities in Tanta City, Gharbia Governorate regarding hypertension and its management, adherence of family physicians and to detect barriers which interfere with their adherence to the guidelines if any. Methods: This is a cross sectional study. It was conducted in Family Health Units of the two main health administration sectors in Tanta City (The first administration sector includes16 units and the second one includes nine units) Tanta, Egypt. The target population of the study was all physicians working in Tanta Family Health Facilities (n=120). This study started from September 2019 and completed in June 2021. Results: Out of physicians, 47 (39.2%) doctors read and implemented guidelines, 37 (30.8%) of physicians heard about it but never had a copy of guidelines and 36 (30%) of them had one but never read the content. More than two thirds 82 (68.3%) of physicians received training about the guidelines but only 68 (56.7%) used these guidelines for management of the patients. The highest percent of physicians had Fair knowledge level (67.5%) about guidelines. Regarding knowledge sub items, definition of guidelines followed by referral criteria and investigations had the highest rank of knowledge level among physicians while treatment, had the lowest rank level. The highest percent of physicians were partially adherent to guidelines (60%). Regarding adherence sub items, measurement of blood pressure followed by history taking had the highest rank among physicians followed by investigation, while treatment and clinical examination had the lowest rank. Conclusion: PHC physicians were found to have a lack of awareness of specific HTN management guidelines as well as inadequately documented practise adherence.