Document Type : Original Article(s)
Authors
- Hossein Farshidi 1
- Marzieh Nikparvar 1
- Iran Rostami-Qeshmi 2
- Roghaieh Ezzati-Rad 3
- Afsoon Piroozan 4
- Elham Boushehri 5
1 Associate Professor, Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2 General Practitioner, Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3 Hormozgan Cardiovascular Research Center AND Department of Health Education, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
4 PhD Candidate, Hormozgan Cardiovascular Research Center AND Department of English Language, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
5 Assistant Professor, Department of Medical Education, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Abstract
BACKGROUND: Hypertension is a common risk factor for developing cardiovascular, brain, and kidney disorders; and today, it affects about one billion people worldwide. Insufficient clinical knowledge of the practitioners and family physicians and not following the guidelines has led to the improper control of hypertension. This study intended to investigate the knowledge, attitude, and practice of general practitioners (GPs) about hypertension in Hormozgan province, Iran.METHODS: This cross-sectional study used consecutive sampling method. A three-part researcher-made questionnaire was used to collect data on demographic, attitude, knowledge, and practice information from 220 GPs working in Hormozgan province.RESULTS: The mean and standard deviation (SD) of scores on knowledge, practice, and attitude of GPs about hypertension management were (5.00 ± 0.50), (10.00 ± 0.02) and (9.00 ± 0.15), respectively; which present a proper state. Attending training courses and increased work experience have statistically significant effects on the knowledge and attitude of GPs (P < 0.050). The only exception was the area of practice, where there was no significant relationship between the practitioners’ work experience and their practice (P = 0.266).CONCLUSION: The results of this study can be utilized by decision-makers and general medicine curriculum designers to plan effective training courses for medical graduates to be used in clinical settings for health promotions.
Keywords
- Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet 2005; 365(9455): 217-23.
- Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics--2013 update: A report from the American Heart Association. Circulation 2013; 127(1): e6-e245.
- Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA 2003; 289(19): 2560-72.
- Noohi F, Sarrafzadegan N, Khosravi A, Andalib E. The first Iranian recommendations on prevention, evaluation and management of high blood pressure. ARYA Atheroscler 2012; 8(3): 97-118.
- Farshidi H, Zare SH, Boushehri E. Association between blood pressure changes and obesity in over-18 population of Bandar Abbas. Hormozgan Med J 2006; 10(2): 111-8.
- Howard G, Prineas R, Moy C, Cushman M, Kellum M, Temple E, et al. Racial and geographic differences in awareness, treatment, and control of hypertension: The Reasons for geographic and racial differences in stroke study. Stroke 2006; 37(5): 1171-8.
- Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 2003; 289(18): 2363-9.
- Agyemang C, Bhopal R. Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data. J Hum Hypertens 2003; 17(8): 523-34.
- Li H, Meng Q, Sun X, Salter A, Briggs NE, Hiller JE. Prevalence, awareness, treatment, and control of hypertension in rural China: Results from Shandong Province. J Hypertens 2010; 28(3): 432-8.
- Braunwald E. Heart disease: A textbook of cardiovascular medicine. Philadelphia, PA: Saunders; 1997.
- Celentano A, Panico S, Palmieri V, Guillaro B, Brancati C, Di Palma Esposito N, et al. Citizens and family doctors facing awareness and management of traditional cardiovascular risk factors: Results from the Global Cardiovascular Risk Reduction Project (Help Your Heart Stay Young Study). Nutr Metab Cardiovasc Dis 2003; 13(4): 211-7.
- Javadi H, Barikani A, Jalilolghadr S. Evaluation of Qazvin general practitioners' attitude on hypertension. J Qazvin Univ Med Sci 2005; 8(4): 53-8. [In Persian].
- World Health Organization, Global atlas on cardiovascular disease prevention and control. Geneva, Switzerland: WHO; 2011.
- Noohi F, Sarrafzadegan N, Khosravi A, Andalib E; First Recommendation on High Blood Pressure Working Group. The first Iranian recommendations on prevention, evaluation and management of high blood pressure. ARYA Atheroscler 2012: 8(3): 97-118.
- Azizi F, Rahmani M, Madjid M, Allahverdian S, Ghanbili J, Ghanbarian A, et al. Serum lipid levels in an Iranian population of children and adolescents: Tehran lipid and glucose study. Eur J Epidemiol 2001; 17(3): 281-8.
- Chen Q, Zhang X, Gu J, Wang T, Zhang Y, Zhu S. General practitioners' hypertension knowledge and training needs: A survey in Xuhui district, Shanghai. BMC Fam Pract 2013; 14: 16.
- Jafar TH, Jessani S, Jafary FH, Ishaq M, Orakzai R, Orakzai S, et al. General practitioners' approach to hypertension in urban Pakistan: Disturbing trends in practice. Circulation 2005; 111(10): 1278-83.
- Khosravi A, Mehr GK, Kelishadi R, Shirani S, Gharipour M, Tavassoli A, et al. The impact of a 6-year comprehensive community trial on the awareness, treatment and control rates of hypertension in Iran: Experiences from the Isfahan healthy heart program. BMC Cardiovasc Disord 2010; 10: 61.
- Al Khaja KA, Sequeira RP, Mathur VS, Damanhori AH, Abdul Wahab AW. Family physicians' and general practitioners' approaches to drug management of diabetic hypertension in primary care. J Eval Clin Pract 2002; 8(1): 19-30.
- Abolfotouh MA, Soliman LA, Abolfotouh SM, Raafat M. Knowledge and Practice of PHC Physicians toward the Detection and Management of Hypertension and Other CVD Risk Factors in Egypt. Int J Hypertens 2011; 2011: 983869.
- Banegas JR, Segura J, Ruilope LM, Luque M, Garcia-Robles R, Campo C, et al. Blood pressure control and physician management of hypertension in hospital hypertension units in Spain. Hypertension 2004; 43(6): 1338-44.
- Huse DM, Roht LH, Alpert JS, Hartz SC. Physicians' knowledge, attitudes, and practice of pharmacologic treatment of hypertension. Ann Pharmacother 2001; 35(10): 1173-9.
- Zibaeenezhad MJ, Babaee H, Vakili SH. Knowledge, attitude and practice of general physicians in treatment and complications of hypertension in Fars province, southern Iran. Iran Red Crescent Med J 2007; 9(1): 4-8.
- Al-Gelban KS, Khan MY, Al-Khaldi YM, Mahfouz AA, Abdelmoneim I, Daffalla A, et al. Adherence of primary health care physicians to hypertension management guidelines in the Aseer region of Saudi Arabia. Saudi J Kidney Dis Transpl 2011; 22(5): 941-8.
- Grandi AM, Maresca AM, Sessa A, Stella R, Ponti D, Barlocco E, et al. Longitudinal study on hypertension control in primary care: The Insubria study. Am J Hypertens 2006; 19(2): 140-5.
- Jafar TH, Islam M, Bux R, Poulter N, Hatcher J, Chaturvedi N, et al. Cost-effectiveness of community-based strategies for blood pressure control in a low-income developing country: Findings from a cluster-randomized, factorial-controlled trial. Circulation 2011; 124(15): 1615-25.
- Banegas JR, Lundelin K, de la Figuera M, de la Cruz JJ, Graciani A, Rodriguez-Artalejo F, et al. Physician perception of blood pressure control and treatment behavior in high-risk hypertensive patients: A cross-sectional study. PLoS One 2011; 6(9): e24569.
- Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999; 282(15): 1458-65.
- Wahner-Roedler DL, Vincent A, Elkin PL, Loehrer LL, Cha SS, Bauer BA. Physicians' attitudes toward complementary and alternative medicine and their knowledge of specific therapies: A survey at an academic medical center. Evid Based Complement Alternat Med 2006; 3(4): 495-501.
- Tasdemir Z, Alkan BA. Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health. Braz Oral Res 2015; 29: 55.
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