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Hypertension management in primary health care: a survey in eight regions of Sweden
University Health Care Research Centre, Örebro University Hospital, Örebro, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.ORCID iD: 0000-0002-1617-6102
Futurum, Region Jönköping County, Jönköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden.
University Health Care Research Centre, Örebro University Hospital, Örebro, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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2023 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 3, p. 343-350Article in journal (Refereed) Published
Abstract [en]

Purpose: To explore hypertension management in primary healthcare (PHC).

Design: Structured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021.

Setting: Seventy-six PHCCs in eight regions of Sweden.

Main outcome measures: Staffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up.

Results: The management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in ≥96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300–11300) patients.

Conclusions: The management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension.

Place, publisher, year, edition, pages
Taylor & Francis, 2023. Vol. 41, no 3, p. 343-350
Keywords [en]
Blood pressure, general practice, hypertension, lifestyle factors, primary health care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-213059DOI: 10.1080/02813432.2023.2242711ISI: 001044894600001PubMedID: 37561134Scopus ID: 2-s2.0-85167700443OAI: oai:DiVA.org:umu-213059DiVA, id: diva2:1790932
Available from: 2023-08-24 Created: 2023-08-24 Last updated: 2023-10-19Bibliographically approved

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Wennberg, PatrikNilsson, Gunnar

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