Journal of Education and Health Promotion

Management of arterial hypertension: Transfer from clinical guidelines into daily practice – Results of a survey in German practitioners offices

Document Type : Original Article

Authors

. Hans-Georg Predel 1
. Fabian Graas 2
. Olaf Randerath 2

1 Institute of Cardiology and Sports Medicine, German Sport University, Cologne, Germany

2 Uzbonn GmbH – Gesellschaft für Empirische Sozialforschung und Evaluation, Bonn, Germany

Abstract
INTRODUCTION: The principal objective of clinical guidelines is to improve the quality of medical
care. However, standardized evaluation of the adoption into daily practice is missing. The aim of our
study was to investigate the implementation of guideline recommendations on the management of
arterial hypertension (AH) in German general practitioner’s (GPs) offices.
METHODS: A questionnaire focusing on the implementation of the German guidelines for the
management of AH was developed and prospectively rolled out in 3.200 GPs and field‑based
specialists in internal medicine in Germany. Data were interpreted in an explorative way.
RESULTS: Data from 689 German physicians that participated in the survey were analyzed.
Effectiveness of lifestyle changes in the management of AH was rated as very high or high in 36.6%.
When lifestyle changes only will not normalize blood pressure (BP), medical treatment will be initiated
after 2–6 months by majority of physicians. Decision for mono‑ or combination therapy was driven
by BP and patient’s risk profile. Choice for a specific antihypertensive substance was based on the
recommendations of scientific guidelines in the majority of GPs.
CONCLUSIONS: Medication treatment algorithms recommended in 2015 by German guidelines
are well accepted by GPs. Lifestyle changes are voted by only slightly more than one‑third as a
reasonable tool for the management of AH in the setting of the medical office. This might reflect a
lack of certified medical education regarding this topic. Our study was not designed to register the
time from publication of guidelines to practical implementation.


Keywords

Arterial hypertension
clinical guidelines
daily practice
implementation
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Journal of Education and Health Promotion
Volume 10, Issue 2
February 2020
Pages 1-6

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