Comparing hypertension guidelines

Scanlon, Thomas; Luben, Robert; Lyle, Pamela

doi:10.1136/bmj.313.7066.1203

Cited by 4 publications

(1 citation statement)

References 2 publications

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“… 26 Other potential causes may be differences in fat distribution, hormones or vascular response between sexes. 27 Also, differences in lifestyle and behaviour could account for this effect. 28 Therefore more exploration on the contribution of sex and age in the probability of being a HCP is recommended to clarify whether or not a gender specific approach will be needed to improve the current differences in blood pressure control between sexes.…”

Section: Discussionmentioning

confidence: 99%

Differences in the classification of hypertensive controlled patient in primary care: Cross sectional study

et al. 2012

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ObjectivesTo examine differences in blood pressure control using the 2006 National Institute for Health and Clinical Excellence (NICE) guidelines and the 2007 Quality and Outcome Framework (QOF) standards.DesignCross-sectional study.Setting28 general practices located in Wandsworth, London.ParticipantsHypertensive patients aged 17 years and over.Main outcomes measuresPercentage of hypertensive patients classified as a hypertensive controlled patient (HCP) by each standard.Results79.5% of patients were classified as a HCP by the QOF target and 60.7% by the NICE target. 93% and 14% of practices had more than 70% of patients classified as a HPC by using the QOF and NICE targets respectively. By applying the QOF target, men aged 45–64 years and 65 years and over had significantly higher probability of being classified as a HCP compared to those aged 17–44 years, OR 1.34 (1.08–.165) and OR 2.15 (1.61–2.87) respectively. Regardless of the target, for men the probability of being classified as a HCP increased with age.ConclusionBetter achievement of blood pressure control targets is present when the less stringent QOF target is used. Men aged 65 years and over were more likely to be classified as a HCP. Greater consistency is needed between the clinical targets in QOF and NICE guidance.

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Section: Discussionmentioning

confidence: 99%

Differences in the classification of hypertensive controlled patient in primary care: Cross sectional study

et al. 2012

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Screening in general practice and primary care

Robson

1998

British Medical Bulletin

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General practice and its associated primary care services are the final common pathway for the delivery of most screening programmes. The absence of nationally agreed priorities, guidelines and identifiable resources has meant that screening in primary care remains somewhat arbitrary, practice varies widely and programmes remain largely unevaluated. Discussion of screening has focused largely on test characteristics and performance with less attention being given to issues of policy formation, priority setting, implementation and quality assurance. Without these elements, quality and test performance deteriorate, recruitment and follow-up are incomplete and a poorly discriminating test of doubtful utility is applied inequitably and inefficiently. For general practice there are two major concerns. The first is to improve delivery of programmes of proven efficacy, such as breast or cervical screening, that already have a national framework. The second is to develop and provide a national structure for preventive programmes for cardiovascular and smoking-related disease. For cardiovascular disease, the issue is no longer whether to screen and advise whole populations for multiple risk factors, but how best to implement this programme. In this chapter, the case for screening for cardiovascular disease is reviewed and potential strategies for improving delivery of screening in general practice and primary care discussed.

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Including practice data to improve evidence‐based guidelines. Example of guidelines on the management of thyroid nodules

Pazart¹,

Massol²,

Matillon³

1998

Evaluation Clinical Practice

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Although clinical guidelines are based on the best evidence available, their proliferation has often failed to change actual practice. One of the many explanations suggested is that there is a gap between the expectations of the targeted professionals and the recommendations in the guidelines. In this study, we attempted to take into account the state of current practice and the physicians' priorities. Using the example of guidelines on the management of thyroid nodules, three different surveys have been conducted: (1) an analysis of physicians' expectations and practice through a postal questionnaire to define appropriate questions; (2) a survey of the professionals' expert opinions, and (3) a prospective study of the use of these guidelines in the management of 253 patients. The results of these surveys have modified the development of the guidelines, and helped us to adapt the content of the guidelines to match physicians' practices more closely.

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Comparing hypertension guidelines

Cited by 4 publications

References 2 publications

Differences in the classification of hypertensive controlled patient in primary care: Cross sectional study

Differences in the classification of hypertensive controlled patient in primary care: Cross sectional study

Screening in general practice and primary care

Including practice data to improve evidence‐based guidelines. Example of guidelines on the management of thyroid nodules

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