Investigating outcomes in the management of hypertension by specialists in a University Hospital
Keywords:Clinical audit, Outcome, Hypertension management, Specialist clinic, UPTH, Nigeria.
Background: Hypertension is an acknowledged risk factor for cardiovascular diseases and this risk is heightened with co-existence of other risk factors and long-term co-morbidities. This study reviewed outcomes in the management of hypertension at the medical outpatient clinic of the University of Port Harcourt Teaching Hospital, Nigeria.
Method: Cross-sectional survey using interviewer-administered questionnaires and review of records of 182 randomly selected regular patients at the medical out-patients’ clinic. Outcomes measured were patients’ adherence to treatment, prevailing/persistent risk factors, co-morbidities, trend in patients’ blood pressure and cholesterol levels over last three consecutive visits. Data were analysis using (SPSS) version 20.0.
Results: Of the 182 patients studied, 37.4% were males and 62.6% females. About half (45.0%) reported adherence to the treatment protocol. The main persisting risk factors were overweight (73.1%) and high low density lipoprotein cholesterol (81.0%) while the commonest co-morbidity was diabetes (26.9%). Proportion of clients with uncontrolled BP progressively declined over the last 3 visits (63.7 à 60.4à 54.4%) though not statistically significant (state p-value). Poor adherence was significantly associated with uncontrolled hypertension (p = 0.004).
Conclusion: Poor adherence with management plan was a significant hindrance to BP control. Findings also suggest benefits in regular follow-up of hypertensive patients. There is need for lifestyle and behavioural modifications in managing hypertension.
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