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.