Commentary: Preparing primary care for the future – perspectives from the Netherlands, England, USA and lessons for Germany

Erler, Antje; Nolte, Ellen; Beyer, Martin; Gerlach, Ferdinand M.

doi:10.1016/j.zefq.2011.09.022

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Regardless of the country and despite the differences in health care systems, whether it be in the United Kingdom, Germany or France, GPs have all put forward logistical difficulties and lack of time to explain their lack of HBPM use in daily practice. [26,37,38]. In addition to the above, other barriers for HBPM implementation emerged from our analysis.…”

Section: Discussionmentioning

confidence: 99%

Implementation of home blood pressure monitoring among French GPs: A long and winding road

et al. 2019

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BackgroundTo explore the perception of home blood pressure monitoring (HBPM) by general practitioners (GPs) in everyday practice in order to identify facilitators and barriers to its implementation in daily practice.MethodsA qualitative study comprising the conduct of six focus groups between October 2016 and February 2017, gathering 41 general practitioners in primary care practice in Lorraine (North Eastern France), with thematic and comprehensive analysis.ResultsThe first reasons given by GPs to explain their difficulties with HBPM (Home Blood Pressure Monitoring) implementation were the usual lack of time, material and human resources. However, all of these motives masked other substantial limiting factors including insufficient knowledge regarding HBPM, poor adherence to recommendations on HBPM and fear of losing their medical authority. GPs admitted that HBPM use could enhance patient observance and decrease therapeutic inertia. Despite this observation, most GPs used HBPM only at the time of diagnosis and rarely for follow-up. One explanation for GP reluctance towards HBPM may be, along with guidelines regarding hypertension, HBPM is perceived as being a binding framework and being difficult to implement. This barrier was more predominantly observed among aging GPs than in young GPs and was less frequent when GPs practiced in multidisciplinary health centers because the logistical barrier was no longer present.DiscussionIn order to improve HBPM implementation in everyday practice in France, it is necessary to focus on GP training and patient education. We must also end "medical power" in hypertension management and turn to multidisciplinary care including nurses, pharmacists and patients.

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Section: Discussionmentioning

confidence: 99%