title: [Objective KONTROL study: therapeutic inertia in hypertensive patients attended in primary care of Spain].
abstract: OBJECTIVE
  To determine the level of therapeutic inertia (TI), and the factors associated to the patient, doctor and the health organisation, in hypertensive patients treated in Primary Care (PC).
  
  
  METHODS
  Cross-sectional, multicentre study.
  
  
  METHODS
  A sample of PC Teams from all over Spain.
  
  
  METHODS
  The study was conducted among PC doctors using a questionnaire and clinical records of 4 patients.
  
  
  METHODS
  The TI was calculated for each patient (TIp) as the proportion of visits in which there was no change in medication when this was indicated.
  
  
  RESULTS
  A total of 543 PC doctors provided data on 2,032 patients, who fulfilled the indication of a change in requirement. There was TI In 77.8% of cases. The TIp observed was non-existent or low for 17.1% of the patients, intermediate for 42% and high for 40.8%. For the patients, the factors most associated with TIp were, age (P<.001), diabetes (P<.001), stroke (P<.01), obesity (P<.01) and a low education level (P<.001). To be female, be less than 40 years or more than 55 years, to be a family doctor with a training program other than MIR and to work in the public sector increased the probability of TIp (P<.001 for all the assumptions).
  
  
  CONCLUSIONS
  The results of the study indicate that there is TI in 7 out every 10 visits made by hypertensive patients in Primary care. There are significant differences as regards the clinical characteristics of the patients and of the doctors.
authors.affiliation: Centro de Salud de Algemesí, Valencia, España. carlsanchis@ono.com
authors.forename: Carlos Sanchis
authors.initials: CS
authors.lastname: Doménech
authors.forename: José Luis Llisterri
authors.initials: JL
authors.lastname: Caro
authors.forename: Vicente Palomo
authors.initials: VP
authors.lastname: Sanz
authors.forename: Francisco Javier Alonso
authors.initials: FJ
authors.lastname: Moreno
authors.forename: Isidro López
authors.initials: IL
authors.lastname: Rodríguez
authors.forename: Armando Nevado
authors.initials: AN
authors.lastname: Loro
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Zamorano
authors.forename: Natividad Gil
authors.initials: NG
authors.lastname: García
authors.forename: M Dolores Aguilar
authors.initials: MD
authors.lastname: Conesa
authors.forename: Pablo
authors.initials: P
authors.lastname: Lázaro Y de Mercado
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D013030:Spain