title: Barriers to adherence to hypertension guidelines among GPs in southern Sweden: a survey.
abstract: OBJECTIVE
  To evaluate barriers to adherence to hypertension guidelines among publicly employed general practitioners (GPs).
  
  
  METHODS
  Questionnaire-based survey distributed to GPs in 24 randomly selected primary care centres in the Region of Skåne in southern Sweden.
  
  
  METHODS
  A total of 109 GPs received a self-administered questionnaire and 90 of them responded.
  
  
  METHODS
  Use of risk assessment programmes. Reasons to postpone or abstain from pharmacological treatment for the management of hypertension.
  
  
  RESULTS
  Reported managing of high blood pressure (BP) varied. In all, 53% (95% CI 42-64%) of the GPs used risk assessment programmes and nine out of 10 acknowledged blood pressure target levels. Only one in 10 did not inform the patients about these levels. The range for immediate initiating pharmacological treatment was a systolic BP 140-220 (median 170) mmHg and diastolic BP 90-110 (median 100) mmHg. One-third (32%; 95% CI 22-42%) of the GPs postponed or abstained from pharmacological treatment of hypertension due to a patient's advanced age. No statistically significant associations were observed between GPs' gender, professional experience (i.e. in terms of specialist family medicine and by number of years in practice), and specific reasons to postpone or abstain from pharmacological treatment of hypertension.
  
  
  CONCLUSIONS
  These data suggest that GPs accept higher blood pressure levels than recommended in clinical guidelines. Old age of the patient seems to be an important barrier among GPs when considering pharmacological treatment for the management of hypertension.
authors.affiliation: Department of Clinical Sciences, Malmö-General Practice/Family Medicine, Lund University, Sweden. patrik.midlov@skane.se
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
authors.forename: Rickard
authors.initials: R
authors.lastname: Ekesbo
authors.forename: Lennart
authors.initials: L
authors.lastname: Johansson
authors.forename: Sofia
authors.initials: S
authors.lastname: Gerward
authors.forename: Kristin
authors.initials: K
authors.lastname: Persson
authors.forename: Christina
authors.initials: C
authors.lastname: Nerbrand
authors.forename: Bo
authors.initials: B
authors.lastname: Hedblad
mesh_terms: D000367:Age Factors; D002983:Clinical Competence; D003151:Community Health Centers; D005194:Family Practice; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden