[Control of arterial hypertension: effectiveness of an intervention performed by family practitioners].
OBJECTIVE
To evaluate the effectiveness of a program to improve hypertension control practices in primary care.


METHODS
Retrospective quasi-experimental study.


METHODS
Three hospital-based family medicine centres (FMCs)


METHODS
Two study groups of 100 randomly-selected adult patients each, who visited the study FMC before implementation of the hypertension program (from April 1, 1983 to March 31, 1984) or afterward (from April 1, 1986 to March 31, 1987). These patients were compared to patients from control FMCs A and B seen during the same time frames (100 patients before and after at FMC A and 60 at FMC B).


METHODS
1) Educational sessions for physicians to standardize knowledge of the recommendations of the Canadian Hypertension Society on hypertension treatment and 2) specific operational incentives to improve hypertension control, including a reference guide placed in each physician's office, a specific hypertension follow-up form placed with each patient's chart, a recall card file, and hypertension information handouts.


METHODS
Blood pressure measurements recorded in patient charts. Hypertension control is determined from the Canadian Hypertension Society recommendations.


RESULTS
The hypertension control rate was 52% in the study group before program implementation and 34.3% afterward (p = 0.01); the corresponding rates in the two control groups moved from 47.4% to 59.8% (p > 0.05) in Group A and from 40.7% to 39.3% (p > 0.05) in Group B. Patients listed in the recall card file were not controlled more frequently (33.3%) than those not listed (35.3%).


CONCLUSIONS
This intervention did not improve physician practice regarding hypertension control. Clinicians did not follow the protocol as recommended. Physicians must be convinced that a change in their practice is needed before any specific strategies are introduced to support the change. Different suggestions and alternatives related to hypertension management are discussed.
Aubin
M
M
Unité de médecine familiale, Hôpital Laval.
Vézina
L
L
Maziade
J
J
Robitaille
N M
NM
D000368:Aged; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education / Q000592:standards; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors
Le contrôle de l'hypertension artérielle: effet d'une intervention réalisée auprès des médecins de famille.