Abstract 329: Barriers To Hypertension Screening, Treatment And Control As Reported By Patients And Healthcare Providers
Notice bibliographique
Résumé
Background: Despite established knowledge on the importance of hypertension (HT) screening and treatment to control blood pressure, the majority of HT patients remain uncontrolled. There are many possible barriers causing this evidence-practice gap, but there is no systematic overview of studies assessing these barriers. This review aims to synthesize findings from the literature on the prevalence and importance of barriers to HT control using a theoretical framework. Methods: Electronic databases MEDLINE, EMBASE and Global Health were systematically searched up to August 2011 and experts in the field were contacted. Two reviewers independently selected eligible studies based on the following criteria: 1) subjects were patients with HT or at risk of HT, or health care providers (HCP) managing HT patients; 2) studies examining barriers, obstacles, or facilitators to HT screening, management, or control; 3) qualitative and quantitative studies. Two reviewers extracted data, including study methodological quality items, and labeled identified barriers by expanding on a theoretical framework for behaviour change. Clinical importance of barriers was assessed by means of association with HT treatment and BP control. Results: Seventeen qualitative studies (10 reporting patient barriers and 7 reporting HCP barriers) and 37 quantitative studies (24 reporting patient barriers, 9 reporting HCP barriers, and 4 reporting both HCP and patient barriers) met the inclusion criteria. Of these, 81% (n=44) were from high income countries. Most studies had methodology issues; most commonly was the bias in measuring barriers. Discrepancies were observed between results from qualitative and quantitative studies. In qualitative studies, environmental barriers, specifically availability of care barriers, were most commonly discussed among patient as well as HCP studies. Results from quantitative studies suggest that among HCP knowledge barriers were most commonly reported (83% of the HCP population). Results for patient reported barriers were different: Intention barriers were the most common barriers to HT screening (reported by 17% of the population), lifestyle change (reported by 37% of the population), and HT treatment adherence (reported by 63% of the population). Knowledge was the most common barrier to overall BP control among patients (reported by 64% of the population). Medication related barriers, specifically side effects, appeared to have the largest effect on HT treatment adherence (HR: 1.91, 95%CI: 1.47-2.47). Conclusions: Barriers to HT control as reported by HCP and patients are multifactorial and largely modifiable, but evidence is primarily from high income countries and not comparable among settings due to methodological limitations. A more systematic way of measuring barriers to HT management is necessary.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».