Primary care guidelines: Senior executives' views on changing health centre practices in hypertension treatment.
OBJECTIVE
To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres.


METHODS
A cross-sectional telephone survey.


METHODS
All municipal health centres in Finland.


METHODS
Health centres where both the head physician and the senior nursing officer responded.


METHODS
Agreement in views of the senior executives on the adoption of clinical practices as recommended in the Hypertension Guideline.


RESULTS
Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p < 0.001) reported that no agreements on recording target blood pressure in patient records existed. A similar discrepancy was seen in recording cardiovascular risk (64% vs. 44%, p < 0.001). Senior executives agreed best on the calibration of sphygmomanometers and the provision of weight-control group counselling.


CONCLUSIONS
Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed.
Ijäs
Jarja
J
Health Centre of the City of Järvenpää
Alanen
Seija
S
Kaila
Minna
M
Ketola
Eeva
E
Nyberg
Solja
S
Välimäki
Maritta A
MA
Mäkelä
Marjukka
M
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003151:Community Health Centers; D005194:Family Practice; D005387:Finland; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D009745:Nursing, Supervisory; D008486:Physician Executives; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents