Management of hypertensive patients in primary health care setting, auditing the practice

OBJECTIVE: To audit the medical care provided to hypertensive patients in a health care center in Riyadh, Kingdom of Saudi Arabia (KSA) and determine the efficient control of hypertension.

METHODS: We carried out this cross-sectional study on all patients who visited the Health Care Specialty Center of King Abdul-Aziz Medical City, Riyadh, KSA for hypertension follow-up during the study period from October to December 2004. A representative sample of patients was allocated randomly using simple randomization method. All patient's records were reviewed for proper recording in a designed form.

RESULTS: Out of the 242 records we reviewed, 201 were included in the study. The patients' mean age was 58.3 ± 12.5 years. All were Saudis and 78.6% were females. Most of them (84.3%) received their management at primary care level only. Age, gender, presence of diabetes, level of medical care, blood glucose, lipid levels and drugs used for management of hypertension were sufficiently recorded. Smoking history, body mass index and family history of ischemic heart disease were poorly recorded. Quarter of the hypertensive patients was sufficiently controlled. The factors associated with poor blood pressure (BP) control were advanced age (p=0.008) and presence of diabetes, [odds ratio (95% CI)=2.98 (1.47-6.08)].

CONCLUSION: The study reflects the deficiencies in BP control and physicians practice. Introducing a checklist or electronic medical records may help the improvement of care. Frequent auditing is recommended to ensure the required development.