caa a22 4500 477057977 CHVBK 20180405111352.0 cr unu---uuuuu 170330e19960301xx s 000 0 eng 10.1007/BF00195929 doi (NATIONALLICENCE)springer-10.1007/BF00195929 How informed general practitioners manage mild hypertension: a survey of readers of drug bulletins in 7 countries [Elektronische Daten] [F. Avanzini, G. Tognoni, F. Colombo, C. Alli, A. Herxheimer] Objective: To determine whether general practitioners (GP) who are readers of independent drug bulletins can be used as an international epidemiological observatory of the criteria adopted by "well informed” doctors in various countries in the management of mild hypertension. Design: Questionnaire study of GPs' diagnostic criteria for mild hypertension, routine investigation and management of patients with this diagnosis. Participants: 206 GPs readers of independent drug bulletins in 7 countries, comprising 95 known systematic readers of a local bulletin and 111 randomly selected regular subscribers. Main outcome measures: Response rate to the questionaire. Diagnostic criteria, routine investigations, and treatment used for patients with mild hypertension. Results: The study required two months for planning and implementation. Four countries out of eleven had a response rate ≤50% and were excluded; the frequency of responses from other countries was 69%. The average diastolic blood pressure (DBP) considered diagnostic of mild hypertension range from 94 mm Hg (lower threshold) to 106 (upper threshold). A minority (17%) of GPs routinely request the minimum recommended laboratory tests to assess patients. GPs routinely advise non-drug measures before starting a drug. Most would not start drug treatment in patients without other risk factors and a DBP below 100 mmHg. The top first choice drugs were diuretics and β-adrenoceptor blockers. Half of the doctors were able to quote some published guide to the management of mild hypertension, and 18% cited a relevant trial. Attitudes in diagnosing and treating mild hypertension differed widely between GPs and countries. Conclusions: GP readers of drug bulletins can be used quickly and inexpensively to assess the extent to which recommended diagnostic and therapeutic practices are accepted by "well informed” doctors. The results suggest that attitudes in managing mild hypertension vary widely among GPs and countries and differ remarkably from the recommendations of published guidelines. Springer-Verlag, 1996 Practioners nationallicence hypertension nationallicence general practice nationallicence disease management nationallicence international differences nationallicence Avanzini F. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, I-20157, Milano, Italy aut Tognoni G. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, I-20157, Milano, Italy aut Colombo F. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, I-20157, Milano, Italy aut Alli C. Ospedale Niguarda, Milan, Italy aut Herxheimer A. UK Cochrane Centre, NHS R and D Programme, OX2 7LG, Oxford, UK aut European Journal of Clinical Pharmacology Springer-Verlag 49/6(1996-03-01), 445-450 0031-6970 49:6<445 1996 49 228 https://doi.org/10.1007/BF00195929 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00195929 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Avanzini F. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, I-20157, Milano, Italy aut NATIONALLICENCE 700 1- Tognoni G. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, I-20157, Milano, Italy aut NATIONALLICENCE 700 1- Colombo F. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, I-20157, Milano, Italy aut NATIONALLICENCE 700 1- Alli C. Ospedale Niguarda, Milan, Italy aut NATIONALLICENCE 700 1- Herxheimer A. UK Cochrane Centre, NHS R and D Programme, OX2 7LG, Oxford, UK aut NATIONALLICENCE 773 0- European Journal of Clinical Pharmacology Springer-Verlag 49/6(1996-03-01), 445-450 0031-6970 49:6<445 1996 49 228 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer