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Hypertension management in minority communities: a clinician survey.
- Source :
- JGIM: Journal of General Internal Medicine; Jan2008, Vol. 23 Issue 1, p81-86, 6p, 4 Charts, 1 Graph
- Publication Year :
- 2008
-
Abstract
- <bold>Background: </bold>Rates of blood pressure (BP) control are lower in minority populations compared to whites.<bold>Objective: </bold>As part of a project to decrease health-related disparities among ethnic groups, we sought to evaluate the knowledge, attitudes, and management practices of clinicians caring for hypertensive patients in a predominantly minority community.<bold>Design/participants: </bold>We developed clinical vignettes of hypertensive patients that varied by comorbidity (type II diabetes mellitus, chronic renal insufficiency, coronary artery disease, or isolated systolic hypertension alone). We randomly assigned patient characteristics, e.g., gender, age, race/ethnicity, to each vignette. We surveyed clinicians in ambulatory clinics of the 4 hospitals in East/Central Harlem, NY.<bold>Measurements: </bold>The analysis used national guidelines to assess the appropriateness of clinicians' stated target BP levels. We also assessed clinicians' attitudes about the likelihood of each patient to achieve adequate BP control, adhere to medications, and return for follow-up.<bold>Results: </bold>Clinicians' target BPs were within 2 mm Hg of the recommendations 9% of the time for renal disease patients, 86% for diabetes, 94% for isolated systolic hypertension, and 99% for coronary disease. BP targets did not vary by patient or clinician characteristics. Clinicians rated African-American patients 8.4% (p = .004) less likely and non-English speaking Hispanic patients 8.1% (p = .051) less likely than white patients to achieve/maintain BP control.<bold>Conclusions: </bold>Clinicians demonstrated adequate knowledge of recommended BP targets, except for patients with renal disease. Clinicians did not vary management by patients' sociodemographics but thought African-American, non-English-speaking Hispanic and unemployed patients were less likely to achieve BP control than their white counterparts. [ABSTRACT FROM AUTHOR]
- Subjects :
- HYPERTENSION
CORONARY disease
BLOOD pressure
CLINICAL trials
EVIDENCE-based medicine
INTERNAL medicine
ATTITUDE (Psychology)
BLOOD pressure measurement
CLINICAL competence
HEALTH services accessibility
HEALTH status indicators
HOSPITAL medical staff
OUTPATIENT services in hospitals
CASE studies
MEDICAL personnel
MINORITIES
PHYSICIAN-patient relations
RACE
RESEARCH funding
PSYCHOLOGY of the sick
CITY dwellers
ACQUISITION of data
CROSS-sectional method
Subjects
Details
- Language :
- English
- ISSN :
- 08848734
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- JGIM: Journal of General Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 32486415
- Full Text :
- https://doi.org/10.1007/s11606-007-0413-z