Are doctors assessing patients with hypertension appropriately at their initial presentation?

Wong, S.L.S. and Lee, P.Y. and Ng, C.J. and Hanafi, N.S. and Chia, Y.C. and Lai, P.S.M. and Liew, S.M. and Khoo, E.M. (2015) Are doctors assessing patients with hypertension appropriately at their initial presentation? Singapore Medical Journal, 59 (09). pp. 518-522. ISSN 0037-5675, DOI

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INTRODUCTION The aim of this study was to determine the extent to which primary care doctors assessed patients newly diagnosed with hypertension for the risk factors of cardiovascular disease (CVD) during the patients’ first clinic visit for hypertension. The study also aimed to examine the trend of assessment for CVD risk factors over a 15-year period. METHODS This retrospective study was conducted between January and May 2012. Data was extracted from the paper-based medical records of patients with hypertension using a 1:4 systematic random sampling method. Data collected included CVD risk factors and a history of target organ damage (TOD), which were identified during the patient’s first visit to the primary care doctor for hypertension, as well as the results of the physical examinations and investigations performed during the same visit. RESULTS A total of 1,060 medical records were reviewed. We found that assessment of CVD risk factors during the first clinic visit for hypertension was poor (5.4%–40.8%). Assessments for a history of TOD were found in only 5.8%–11.8% of the records, and documented physical examinations and investigations for the assessment of TOD and secondary hypertension ranged from 0.1%–63.3%. Over time, there was a decreasing trend in the percentage of documented physical examinations performed, but an increasing trend in the percentage of investigations ordered. CONCLUSION There was poor assessment of the patients’ CVD risk factors, secondary causes of hypertension and TOD at their first clinic visit for hypertension. The trends observed in the assessment suggest an over-reliance on investigations over clinical examinations.

Item Type: Article
Funders: Institute of Research Management & Monitoring University Malaya Research Grant RG335/11HTM
Uncontrolled Keywords: Cardiovascular disease; End-organ damage; First visit; Hypertension; Risk factor
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 28 Sep 2018 02:41
Last Modified: 28 Sep 2018 02:41

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