La prise en charge de l'hypertension artérielle en ambulatoire par les médecins généralistes au niveau des ESSP à Rabat

Abstract

IntroductionHypertension is a public health problem at the national and international level because of its morbidity, mortality and management costs. MethodsThis is a cross-sectional, descriptive study conducted in the PHCF in Rabat among general practitioners (GPs) providing care for hypertensive patients in order to identify their knowledge and practices. The study was conducted over a period of 6 months from March to September 2019. The objective of the study is to explore the management of hypertension by general practitioners at the level of the PHCF in Rabat with the aim of proposing avenues for improvement. ResultsA total of 77 general practitioners (GPs) participated in this study. Systematic screening for hypertension was performed by 20∕77 (27%) of the physicians participating in the study. 34∕77 (55%) GPs followed the guidelines, the rest of the GPs reported not following the guidelines due to the socio-economic level of the patients and also due to lack of training. The majority of physicians were able to define hypertension and respected the rules of blood pressure measurement, the assessment of cardiovascular risk was performed by almost all physicians but overall, without calculation with the tables. The most prescribed drugs were calcium channel blockers (45%), followed by ACE inhibitors (26%), angiotensin antagonists (23%), and diuretics (14%). The majority of GPs 92% advocated monotherapy in the first, dual therapy was indicated in case of associated risk, and if monotherapy failed, half of the physicians advocated full-dose monotherapy. ConclusionThis study showed that there are several problems in the management of hypertension in our health centers (eligibility, performance of the assessment required for all hypertensive patients and application of the recommended treatment, non-adherence of physicians to the guidelines). This has led to the recommendation to reinforce the continuous training of physicians, the collaboration with specialists and the availability of human and material resources.