title: Health practitioners' state of knowledge and challenges to effective management of hypertension at primary level.
abstract: BACKGROUND
  Patient- and physician-related factors impact on the management and control of hypertension.
  
  
  OBJECTIVE
  To systematically examine: (1) South African primary care doctors' state of knowledge on the management of hypertension; (2) primary health practitioners' knowledge on the South African hypertension guidelines; (3) current approaches to management of hypertensive patients; and (4) challenges to effective management of hypertension at primary level.
  
  
  METHODS
  A cross-sectional, observational study using a semi-structured questionnaire was carried out in two large community health centres (CHCs) in the Cape Town metropole. All 16 doctors employed at both CHCs were voluntarily enrolled, seven (43.7%) of whom were female, with 14 (87.5%) younger than 40 years of age. The majority (81.2%) of the doctors surveyed had been practicing for less than 10 years.
  
  
  RESULTS
  Ten (62.5%) of the doctors surveyed aimed to treat hypertension to target, and recommendations on lifestyle modifications were reportedly poorly done. While 11 (68.8%) of the doctors were aware of the South African hypertension guidelines, were (81.8%) of them were not conversant with the contents thereof. Doctors estimated that only 35% of their patients are treated to target. Poor patient adherence to prescribed treatment, language difficulty, heavy patient load, medical staff shortages, and patient loss to follow up were identified by the doctors as significant impediments to the effective management of hypertension at the primary level of care.
  
  
  CONCLUSIONS
  Primary healthcare practitioners' knowledge regarding hypertension and the South African hypertension guidelines is poor. Management of hypertension by these doctors is sub-optimal. There are significant challenges to effective management of hypertension at this level of care.
authors: Department of Medicine, University of Cape Town, South Africa.
authors: A
authors: A
authors: Parker
authors: B
authors: B
authors: Nagar
authors: G
authors: G
authors: Thomas
authors: M
authors: M
authors: Badri
authors: N B A
authors: NB
authors: Ntusi
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001364:Awareness; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents