RT Journal Article
SR Electronic
T1 Self-monitoring blood pressure in patients with hypertension: an internet-based survey of UK GPs
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e831
OP e837
DO 10.3399/bjgp16X687037
VO 66
IS 652
A1 Benjamin R Fletcher
A1 Lisa Hinton
A1 Emma P Bray
A1 Andrew Hayen
A1 FD Richard Hobbs
A1 Jonathan Mant
A1 John F Potter
A1 Richard J McManus
YR 2016
UL http://bjgp.org/content/66/652/e831.abstract
AB Background Previous research suggests that most GPs in the UK use self-monitoring of blood pressure (SMBP) to monitor the control of hypertension rather than for diagnosis. This study sought to assess current practice in the use of self-monitoring and any changes in practice following more recent guideline recommendations.Aim To survey the views and practice of UK GPs in 2015 with regard to SMBP and compare them with a previous survey carried out in 2011.Design and setting Web-based survey of a regionally representative sample of 300 UK GPs.Method GPs completed an online questionnaire concerning the use of SMBP in the management of hypertension. Analyses comprised descriptive statistics, tests for between-group differences (z, Wilcoxon signed-rank, and χ2 tests), and multivariate logistic regression.Results Results were available for 300 GPs (94% of those who started the survey). GPs reported using self-monitoring to diagnose hypertension (169/291; 58%; 95% confidence interval (CI) = 52 to 64) and to monitor control (245/291; 84%; 95% CI = 80 to 88), the former having significantly increased since 2011 (from 37%; 95% CI = 33 to 41; P<0.001) with no change in monitoring for control. More than half of GPs used higher systolic thresholds for diagnosis (118/169; 70%; 95% CI = 63 to 77) and treatment (168/225; 75%; 95% CI = 69 to 80) than recommended in guidelines, and under half (120/289; 42%; 95% CI = 36 to 47) adjusted the SMBP results to guide treatment decisions.Conclusion Since new UK national guidance in 2011, GPs are more likely to use SMBP to diagnose hypertension. However, significant proportions of GPs continue to use non-standard diagnostic and monitoring thresholds. The use of out-of-office methods to improve the accuracy of diagnosis is unlikely to be beneficial if suboptimal thresholds are used.