Treatment preferences, return visit planning and factors affecting hypertension practice amongst general practitioners and internal medicine specialists (the General Practitioner Hypertension Practice Study)

Abstract

Objectives: To study clinical practice and attitudes in hypertension care amongst general practitioners (GPs) and hospital internal medicine specialists.

Design: Mailed case report questionnaires.

Subjects: Ninety GPs and 69 internal medicine specialists at randomly selected primary health care centres and hospital outpatient departments.

Main outcome measures: Case-bound treatment preferences, treatment goals and return visit planning, and views on factors influencing practice.

Results: The participation rate was 84% and 70%, for GPs and internal medicine specialists, respectively. GPs more often proposed nonpharmacological therapy (P < 0.05), solely and as a complementary treatment, and prescribed more calcium antagonists (P < 0.001), whilst internal medicine specialists prescribed more ACE inhibitors (P < 0.001). Personal experience guides practice more than national consensus and economy, more so with increasing time since specialization.

Conclusions: GPs and internal medicine specialists in Sweden report a hypertension practice closely related to each others' and to the intentions of national guidelines.