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Australian Family Physician
Australian Family Physician

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Volume 39, Issue 7, July 2010

Barriers to diagnosing and managing hypertension A qualitative study in Australian general practice

Danielle Williams Emily Hansen Mark Nelson Faline S Howes
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Background
Elevated blood pressure (BP) is a major modifiable risk factor. However hypertension still remains underdiagnosed, untreated or suboptimally treated. This study aimed to identify and explore barriers to initiating medication and treating elevated BP to target levels in the general practice setting.
Discussion
The management of an asymptomatic chronic disease within a patient centred, encounter based primary care context can be challenging.
Results
After making the decision to commence treatment, medication initiation was relatively straightforward. Clinical uncertainty about true underlying BP, distrust of measurement technology, and distrust of the evidence underpinning hypertension management were expressed. Patient age, gender and comorbidity influenced treatment strategy. Related themes included perceived patient attitude, clinical inertia, and patient centred care. Systems issues included lack of resources and lack of time.

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