Perceptions and assessment of physicians and patients regarding the regulation of arterial hypertension in primary health care

OBJECTIVE Hypertension affects one third of the world population and is one of the most common conditions encountered in primary health care. Although the effective treatment of hypertension has been found to prevent related disease and to improve quality of life, the condition remains under-controlled worldwide. A decisive role in the final therapeutic effect is played by the discrepancy between the perceptions of doctors and patients about the condition and its regulation. The study investigates the perceptions of patients and physicians about hypertension and is aimed at identifying discrepancies in the management of the disease which may result in a low rate of successful treatment. METHOD The study was conducted in primary care facilities, using two questionnaires for collecting data from patients with hypertension and doctors, respectively. RESULTS The patients reported satisfactory self-assessed compliance in taking their medication, but 42.2% of them stated that they delay their drug doses, with higher frequency in those receiving more than two formulations, and 23.3% that they stop treatment when they feel better without consulting the physician. A discrepancy was observed between doctors and patients regarding whether the patients are consistent in taking their medication and the patients' knowledge about issues related to their condition. Regarding discontinuing treatment without informing their doctor when they feel worse, 95.7% of patients denied doing this, as opposed to 33% of doctors who reported this practice. On self-measurement, 65.5% of patients stated that are able to measure their own blood pressure correctly, while only 30% of doctors believe that this is true. On control of hypertension, 65.5% of the patients reported that always or often have their disease under control, whereas 61.7% of doctors consider that this is achieved only sometimes. CONCLUSIONS The findings of this study highlight the need for doctors in primary health care to improve their communication skills, to implement guidelines based on standardized steps, to keep patient electronic medical documentation and to develop direct methods of clinical evaluation for achieving treatment goals in patients with hypertension.