[Assessment of the quality of management of arterial hypertension in a public health center (Ariana - Tunisia)].
The management of hypertensive outpatients in a primary health care center raises problems of follow-up and effectiveness. This study attempts to assess the management of high blood pressure, using the Medical Audit method, essentially. For that purpose, 194 medical records of hypertensive outpatients registered between 1980 and 1986 were studied. More than 80% of these patients were women between the ages of 40 and 70 years. The medical records of these patients were compared to a standard management scale including 68 items devised by cardiologists and general practitioners. Globally, 32% of the items were cardiologists and general practitioners. Globally, 32% of the items were respected during management of the outpatients. The initial check-up was the least followed item (6.9%), but afterwards care of patients improved, giving ratings of: 29% for respect of treatment protocol, and 35% for surveillance of treatment. As concerns treatment effectiveness, only 28% of the patients (n = 36) actually completed the five-year follow-up period. In these patients average blood pressure fell from 193 to 143 mmHg (systolic), and from 113 to 93 mmHg (diastolic), between the beginning of monitoring and the end of the fifth year. The insufficiency of high blood pressure management results not only from a shortage of resources, but also from underuse of existing ones, and the practitioners' lack of information.
Ben Hamida
A
A
Département de Médecine Préventive et Sociale, Faculté de Médecine de Tunis.
Oueslati
F
F
Bouraoui
L
L
Zouari
B
B
Nacef
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000592:standards*; D003151:Community Health Centers; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010349:Patient Compliance; D015397:Program Evaluation; D014416:Tunisia
Evaluation de la qualité de la prise en charge de l'hypertension artérielle dans un centre de santé de base public (Ariana-Tunis).