Is blood pressure measured correctly in dialysis centres? Physicians' and patients' views

Pappaccogli, Marco; Labriola, Laura; Pruijm, Menno; Vogt, Liffert; Ferro, Charles J.; Halabi, Georges; Phan, Olivier; Bullani, Roberto; Saudan, Patrick; Avdelidou, Afroditi; Panou, Eleni; Papoulidou, Fani; London, Gérard M.; Rossignol, Patrick; Sarafidis, Pantelis A.; Persu, Alexandre; Wuerzner, Grégoire

doi:10.1093/ndt/gfz125

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…It would be of interest to complement this study by a survey involving patients followed in the same centres and to compare, for example, the time dedicated to discussing medications as reported by HCPs and patients. Such an approach was recently used to analyse the quality of BP measurements in dialysis centers [31]. Lastly, participants completing our survey were free to participate.…”

Section: Discussionmentioning

confidence: 99%

Hypertension healthcare professional beliefs and behaviour regarding patient medication adherence: a survey conducted among European Society of Hypertension Centres of Excellence

Burnier¹,

Prejbisz

Weber

et al. 2021

Blood Pressure

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Purpose: Little is known on the beliefs, perceptions and practices of hypertension specialists in addressing non-adherence to therapy. Therefore, a survey was undertaken amongst healthcare professionals (HCPs) managing hypertension in the European Society of Hypertension (ESH) Centres of Excellence. Materials and methods: Cross-sectional data were obtained between December 2020 and April 2021 using an online anonymous structured questionnaire including 26 questions/136 items, that was sent to all ESH Excellence centres. Results: Overall 67 from 187 centres (37.3%) responded and 200 HCPs from 30 countries answered the questionnaire. Participants (60% men) were mainly physicians (91%) and nurses (8%) from University hospitals (77%). Among physicians, 83% had >10 years professional experience. Average time dedicated to discuss medications was 1-5 min in 48% and 6-10 min in 29% of cases. Interviews with patients about adherence were the most frequently used assessment method. Chemical detection of medications in urine was available in 36% of centres. One third of physicians involved their patients regularly in treatment decisions. The most frequent methods to improve adherence included simplification of medication therapy, more frequent visits, and home blood pressure monitoring. Conclusions: The level of implementation of tools to detect and improve adherence in hypertension management by HCPs in ESH excellence centres is low. Structured educational activities focussing on adherence management and access to the newest objective measures to detect non-adherence might improve these deficits.

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Section: Discussionmentioning

confidence: 99%

Hypertension healthcare professional beliefs and behaviour regarding patient medication adherence: a survey conducted among European Society of Hypertension Centres of Excellence

Burnier¹,

Prejbisz

Weber

et al. 2021

Blood Pressure

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“…Firstly, it should be acknowledged that routinely collected peri‐dialytic BP measurements are often performed under suboptimal conditions and may, therefore, be unreliable as a means to predict risk of cardiovascular events, diagnose hypertension, and guide treatment. A recent survey conducted across 92 predominantly European HD centers supports this assertion 8 . Usual BP measurement practice fell significantly below recommended standards, with only 20% of HD units achieving at least 80% of standards 8 .…”

Section: Blood Pressure Targets In Hemodialysis Patientsmentioning

confidence: 99%

“…A recent survey conducted across 92 predominantly European HD centers supports this assertion 8 . Usual BP measurement practice fell significantly below recommended standards, with only 20% of HD units achieving at least 80% of standards 8 . The reasons for sub‐optimal BP measurement were not explored but, intuitively, patient‐related factors are likely to exert a significant influence on measurement practice and/or BP readings themselves.…”

Section: Blood Pressure Targets In Hemodialysis Patientsmentioning

confidence: 99%

Uncertainties in BP management in dialysis patients

Doulton

Swift

Murtaza

et al. 2020

Seminars in Dialysis

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Hypertension in dialysis patients is extremely common. In this article, we review the current evidence for blood pressure (BP) goals in hemodialysis patients, and consider the effectiveness of interventions by which BP may be lowered, including manipulation of dietary and dialysate sodium; optimization of extracellular water; prolongation of dialysis time; and antihypertensive medication. Although two meta-analyses suggest lowering BP using antihypertensive drugs might be beneficial in reducing cardiovascular events and mortality, there are insufficient rigorously designed trials in hypertensive hemodialysis populations to determine preferred antihypertensive drug classes. We suggest aiming for predialysis systolic BP between 130 and 159 mm Hg, while at the same time acknowledge the significant limitations of the data upon which it is based. We conclude by summarizing current knowledge as regards management of hypertension in the peritoneal dialysis population and make recommendations for future research in this field.

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