Implementation of home blood pressure monitoring among French GPs: A long and winding road


Autoři: Giselle Dugelay aff001;  Joëlle Kivits aff002;  Louise Desse aff001;  Jean-Marc Boivin aff001
Působiště autorů: Université de Lorraine, Département de Médecine Générale, Nancy, France aff001;  Université de Lorraine, École de Santé Publique, Nancy, France aff002;  Université de Lorraine, Apemac, Nancy, France aff003;  Centre d’Investigations Clinique Plurithématique 1433 (CIC-P), Inserm, CHRU de Nancy, Nancy, France aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0220460

Souhrn

Background

To explore the perception of home blood pressure monitoring (HBPM) by general practitioners (GPs) in everyday practice in order to identify facilitators and barriers to its implementation in daily practice.

Methods

A qualitative study comprising the conduct of six focus groups between October 2016 and February 2017, gathering 41 general practitioners in primary care practice in Lorraine (North Eastern France), with thematic and comprehensive analysis.

Results

The first reasons given by GPs to explain their difficulties with HBPM (Home Blood Pressure Monitoring) implementation were the usual lack of time, material and human resources. However, all of these motives masked other substantial limiting factors including insufficient knowledge regarding HBPM, poor adherence to recommendations on HBPM and fear of losing their medical authority. GPs admitted that HBPM use could enhance patient observance and decrease therapeutic inertia. Despite this observation, most GPs used HBPM only at the time of diagnosis and rarely for follow-up. One explanation for GP reluctance towards HBPM may be, along with guidelines regarding hypertension, HBPM is perceived as being a binding framework and being difficult to implement. This barrier was more predominantly observed among aging GPs than in young GPs and was less frequent when GPs practiced in multidisciplinary health centers because the logistical barrier was no longer present.

Discussion

In order to improve HBPM implementation in everyday practice in France, it is necessary to focus on GP training and patient education. We must also end "medical power" in hypertension management and turn to multidisciplinary care including nurses, pharmacists and patients.

Klíčová slova:

Medicine and health sciences – Vascular medicine – Blood pressure – Hypertension – Health care – Health care providers – Medical doctors – Physicians – General practitioners – Patients – Physical sciences – Physics – Classical mechanics – Motion – Inertia – People and places – Population groupings – Professions – Medical personnel – Geographical locations – Europe – European Union – France – Biology and life sciences – Bioengineering – Biotechnology – Medical devices and equipment – Engineering and technology


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2019 Číslo 9
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