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Improving Blood Pressure Controls in Primary Care Settings
pressure is 50.1 was almost the same with those who had no knowledge of normal blood pressure range. Majority of the
respondents 55.8 were aware of their own latest blood pressure. Majority of the respondents 77.6 claimed that they had good
compliance to antihypertensive drugs.
4.1.3 Focus group discussion
Participants are medical officers, medical assistants and nurses in charge of outpatients’ clinic in all intervention clinics in all
three districts. The sessions were held separately conducted by researchers of respective districts.
Aims of the sessions are to explore the problems that might affect the management of patients thus their outcome and finally to get
the opinions regarding ways to improve blood pressure control. The FGD mainly focused on the knowledge of the health care provider
regarding the standard and latest management of hypertension according to the Clinical Practice Guidelines CPG.
FGD were carried out in all intervention and control clinics among the staff that involved in clinical the management of hypertensive
patients who are medical officers, medical assistants, staff nurses and community nurses. The sessions took place in the clinic
meeting room during the non busy afternoon for duration of at least 1 hour.
From that discussion we found several major problems, 1.
Almost all paramedics and nurses admitted that they never used the CPG in management of hypertensive patients as
opposed to medical officers.
2. Majority of paramedics and nurses have limited knowledge
about hypertensive disease. 3.
Majority of paramedics have limited knowledge regarding the range of hypertensive drugs and dosage
4. Almost all staff said they were overloaded with work because
lack of staff and as a result they could not give their best in the management of patients.
5. Many medical officers said that their treatment is limited by
the availability of latest drugs. 6.
Most staff said there lack of structured programmes on management of hypertension in their clinics such as CME.
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Improving Blood Pressure Controls in Primary Care Settings
7. Some medical officers raised the need for resources centre
so that they can update their knowledge. 8.
Most staff said there is lack of promotional programmes on hypertension such as seminar for patients as opposed to
normal one to one counseling.
9. Some medical officers also raised the need for structured
hypertensive medical notes.
4.2 Phase II
4.2.1 Pre intervention data collection
A total of 300 patients comprised of 117 males 39 and 183 females 61 with their baseline blood pressure taken. They have
the mean SBP of 139.87 and DBP of 84.56. Only 132 44 out of the 300 patients have controlled blood pressure.
4.2.2 Implementation of Intervention packages
From January the intervention packages are implemented in intervention clinics as follows:
1. The flow chart on the management of hypertension were
developed and distributed to the 6 interventions clinics to be displayed in the rooms.
2. First training to the medical officers, paramedics and nurses
in each district of intervention clinics involved in clinical management of hypertensive management conducted on
26
th
January 2007. Table 4
Table 4. The distribution of healthcare professionals trained in management of hypertension in selected primary health clinics
Districts
Intervention Clinics Clinics
MO MA
Nurses
Perak Tengah Bota Kiri
Kg. Gajah 1
1 2
2 5
1
Manjung Pulau Pangkor
Pantai Remis 2
1 3
2 2
3
Kerian Bagan Serai
Tanjung Piandang 1
1 2
2 4
2 Total
7 13
17
