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Submitted: 15 April 2019 Modified: 17 July 2019
HERDIN Record #: 100731-19041511060221

Quality of care for patients with hypertension at the Philippine Heart Center.

Maribel C. Gonzales

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Background: Despite the availability of a wide range of anti-hypertensive drugs, hypertension and its complications are still important causes of adult morbidity and mortality worldwide.1 In the Philippines, the overall prevalence of hypertension based on a single visit blood pressure was 22.5%.2


Objectives: This study aims to assess the extent of adherence of physicians to the international guidelines in the management of hypertension. It is also the aim of this study to determine types of anti-hypertensive drugs frequently prescribed by the attending physician.


Methodology: This is a retrospective, cross-sectional analytic study. Data of patients from the Philippine Heart Center (PHC) hypertension clinic were reviewed. Demographic details, co-morbidities, and anti-hypertensive drugs used were recorded. To assess the quality of care, Explicit Criteria for lNC VII Adherence Tool5 was utilized. The tool assigns a score to each individual criterion as either "met" (l) or "unmet" (0). For patients for whom the criterion does not apply, the tool assigns a score of"9" .


Results: Three hundred charts were reviewed and included in the study. Mean age was 60 years old, 71 percent were female and 29 percent were male. All patients belong to stage 2 category of hypertension. Beta blocker is the most commonly prescribed drug (49%) either alone or in combination, followed by calcium channel blocker (44%). Sixty-ieght percent of the study population is currently on multiple drugs regimen. The score for the diagnosis and drug therapy criteria were 88% and 81% respectively which clearly indicates an optimal care if a 70% arbitrary cut off score will be use. However, the follow-up and monitoring criteria were only 53% and 61% respectively which obviously showed a sub-optimal care.


Conclusion: Follow up and treatment for patients with uncontrolled hypertension needs an improvement. For diabetic patients, screening for proteinuria should be routinely performed. One of the probable cause of a low score in laboratory monitoring criteria is financial constraint. As physician, we should know how to prioritize what diagnostics are appropriate for a particular patient.

Publication Type
Research Report
Date
January 1-December 31, 2009
LocationLocation CodeAvailable FormatAvailability
Philippine Heart Center Medical Library PHC.IR.020.09 Abstract Print Format