Skip to main content
Top
Published in: BMC Primary Care 1/2021

Open Access 01-12-2021 | Blood Pressure Measurement | Research article

Home blood-pressure measurement for the diagnosis and monitoring of arterial hypertension by French general practitioners: a cross-sectional survey in the Auvergne region

Authors: Mangiavillano Xavier, Tréfond Jéromine, Plaquevent-Hostache Guillaume, Tanguy Gilles, Bœuf-Gibot Sylvaine, Mulliez Aurélien, Vorilhon Philippe

Published in: BMC Primary Care | Issue 1/2021

Login to get access

Abstract

Background

Home blood-pressure measurement (HBPM) is recommended for the diagnosis of hypertension and monitoring of patients with hypertension. Since 2013, the French National Health Insurance Body (FNHIB) has promoted HBPM to general practitioners (GPs). The objective of the study was to evaluate the practice of HBPM by French GPs to diagnose and monitor hypertension, 3 years after the beginning of the FNHIB campaign.

Methods

We conducted a postal survey from 7 March to 31 May 2016. All of the 1040 GPs practising in the Auvergne region in France were invited to participate, using a self-reporting questionnaire. We obtained information on the characteristics of the GPs, and their practice regarding the use of HBPM. Use of HBPM was reported as “never, occasionally, regularly and systematically”. Frequency of HBMP use was analysed using multivariate ordered logistic regression model.

Results

A total of 569 (54.7%) GPs responded to the survey. They were 50.3 (± 11.5) years old, 241 (43.0%) were female, and 352 (62.7%) worked in urban areas. Among them, 530 (94.5%) reported the use of HBPM for diagnosis and 519 (92.5%) for monitoring hypertension. To diagnose hypertension, younger GPs (OR = 0.97; 95% CI: 0.95–0.98), GPs practising in a group (OR = 1.45; 95% CI: 1.00–2.10) and in an MHC (OR = 2.09; 95% CI: 1.15–3.78), as compared to GPs with individual practices, and Clinical Tutors, as compared to non-Clinical Tutors, (OR = 1.92; 95% CI: 1.33–2.79) reported more frequent use of HBPM. To manage hypertension, female GPs, as compared to male GPs, (OR=1.47; 95% CI: 1.04–2.06), younger GPs (OR = 0.98; 95% CI: 0.97–0.99), and Clinical Tutors (OR = 1.90; 95% CI: 1.31–2.75) reported more frequent use of HBPM.

Conclusions

Our survey reveals that 3 years after the introduction of the FNHIB incentives, the use of HBPM by participating GPs to diagnose and manage hypertension is well established. A larger survey of GPs from other regions would make it possible to verify whether our results can be extrapolated to France as a whole.
Appendix
Available only for authorised users
Literature
1.
go back to reference Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36:1953–2041.CrossRef Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36:1953–2041.CrossRef
2.
go back to reference Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14:e1002389.CrossRef Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14:e1002389.CrossRef
3.
go back to reference Blacher J, Halimi J-M, Hanon O, Mourad J-J, Pathak A, Schnebert B, et al. Prise en charge de l’hypertension artérielle de l’adulte. Recommandations 2013 de la Société française d’hypertension artérielle. Ann Cardiol Angeiol. 2013;62:132–8.CrossRef Blacher J, Halimi J-M, Hanon O, Mourad J-J, Pathak A, Schnebert B, et al. Prise en charge de l’hypertension artérielle de l’adulte. Recommandations 2013 de la Société française d’hypertension artérielle. Ann Cardiol Angeiol. 2013;62:132–8.CrossRef
4.
go back to reference Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and Management of High Blood Pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Hypertension. 2018;71:1269–324.CrossRef Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and Management of High Blood Pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Hypertension. 2018;71:1269–324.CrossRef
6.
go back to reference Turana Y, Tengkawan J, Soenarta AA. Asian management of hypertension: current status, home blood pressure, and specific concerns in Indonesia. J Clin Hypertens (Greenwich). 2020;22:483–5.CrossRef Turana Y, Tengkawan J, Soenarta AA. Asian management of hypertension: current status, home blood pressure, and specific concerns in Indonesia. J Clin Hypertens (Greenwich). 2020;22:483–5.CrossRef
7.
go back to reference Fletcher BR, Hinton L, Hartmann-Boyce J, Roberts NW, Bobrovitz N, McManus RJ. Self-monitoring blood pressure in hypertension, patient and provider perspectives: a systematic review and thematic synthesis. Patient Educ Couns. 2016;99:210–9.CrossRef Fletcher BR, Hinton L, Hartmann-Boyce J, Roberts NW, Bobrovitz N, McManus RJ. Self-monitoring blood pressure in hypertension, patient and provider perspectives: a systematic review and thematic synthesis. Patient Educ Couns. 2016;99:210–9.CrossRef
8.
go back to reference Carter EJ, Moise N, Alcántara C, Sullivan AM, Kronish IM. Patient barriers and facilitators to ambulatory and home blood pressure monitoring: a qualitative study. Am J Hypertens. 2018;31:919–27.CrossRef Carter EJ, Moise N, Alcántara C, Sullivan AM, Kronish IM. Patient barriers and facilitators to ambulatory and home blood pressure monitoring: a qualitative study. Am J Hypertens. 2018;31:919–27.CrossRef
9.
go back to reference Lee EKP, Choi RCM, Liu L, Gao T, Yip BHK, Wong SYS. Preference of blood pressure measurement methods by primary care doctors in Hong Kong: a cross-sectional survey. BMC Fam Pract. 2020;21:95.CrossRef Lee EKP, Choi RCM, Liu L, Gao T, Yip BHK, Wong SYS. Preference of blood pressure measurement methods by primary care doctors in Hong Kong: a cross-sectional survey. BMC Fam Pract. 2020;21:95.CrossRef
10.
go back to reference Tirabassi J, Fang J, Ayala C. Attitudes of primary care providers and recommendations of home blood pressure monitoring--DocStyles, 2010. J Clin Hypertens. 2013;15:224–9.CrossRef Tirabassi J, Fang J, Ayala C. Attitudes of primary care providers and recommendations of home blood pressure monitoring--DocStyles, 2010. J Clin Hypertens. 2013;15:224–9.CrossRef
11.
go back to reference Vaïsse B, Mourad J-J, Girerd X, Hanon O, Halimi J-M, Pannier B. Enquête FLAHS 2012: la pratique de l’automesure tensionnelle en France et son évolution depuis 2010. Ann Cardiol Angeiol. 2013;62:200–3.CrossRef Vaïsse B, Mourad J-J, Girerd X, Hanon O, Halimi J-M, Pannier B. Enquête FLAHS 2012: la pratique de l’automesure tensionnelle en France et son évolution depuis 2010. Ann Cardiol Angeiol. 2013;62:200–3.CrossRef
12.
go back to reference Dugelay G, Kivits J, Desse L, Boivin J-M. Implementation of home blood pressure monitoring among French GPs: a long and winding road. PLoS One. 2019;14:e0220460.CrossRef Dugelay G, Kivits J, Desse L, Boivin J-M. Implementation of home blood pressure monitoring among French GPs: a long and winding road. PLoS One. 2019;14:e0220460.CrossRef
15.
go back to reference Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013_ESH/ESC_Guidelines_for_the_management_of arteriel hypertension. TheTask force for the management ofarterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.CrossRef Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013_ESH/ESC_Guidelines_for_the_management_of arteriel hypertension. TheTask force for the management ofarterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.CrossRef
16.
go back to reference Kaczorowski J, Myers M, Gelfer M, Dawes M, Mang E, Berg A, et al. How do family physicians measure blood pressure in routine clinical practice? National survey of Canadian family physicians. Can Fam Physician. 2017;63:193–9. Kaczorowski J, Myers M, Gelfer M, Dawes M, Mang E, Berg A, et al. How do family physicians measure blood pressure in routine clinical practice? National survey of Canadian family physicians. Can Fam Physician. 2017;63:193–9.
17.
go back to reference Sala C, Santin E, Rescaldani M, Magrini F. How long shall the patient rest before clinic blood pressure measurement? Am J Hypertens. 2006;19:713–7.CrossRef Sala C, Santin E, Rescaldani M, Magrini F. How long shall the patient rest before clinic blood pressure measurement? Am J Hypertens. 2006;19:713–7.CrossRef
18.
go back to reference Riegel B, Jaarsma T, Strömberg A. A middle-range theory of self-care of chronic illness. ANS Adv Nurs Sci. 2012;35:194–204.CrossRef Riegel B, Jaarsma T, Strömberg A. A middle-range theory of self-care of chronic illness. ANS Adv Nurs Sci. 2012;35:194–204.CrossRef
19.
go back to reference Boivin J-M, Tsou-Gaillet T-J, Fay R, Dobre D, Rossignol P, Zannad F. Influence of the recommendations on the implementation of home blood pressure measurement by French general practitioners: a 2004-2009 longitudinal survey. J Hypertens. 2011;29:2105–15.CrossRef Boivin J-M, Tsou-Gaillet T-J, Fay R, Dobre D, Rossignol P, Zannad F. Influence of the recommendations on the implementation of home blood pressure measurement by French general practitioners: a 2004-2009 longitudinal survey. J Hypertens. 2011;29:2105–15.CrossRef
20.
go back to reference Tislér A, Dunai A, Keszei A, Fekete B, Othmane TEH, Torzsa P, et al. Primary-care physicians’ views about the use of home/self blood pressure monitoring: nationwide survey in Hungary. J of Hypertens. 2006;24:1729–35.CrossRef Tislér A, Dunai A, Keszei A, Fekete B, Othmane TEH, Torzsa P, et al. Primary-care physicians’ views about the use of home/self blood pressure monitoring: nationwide survey in Hungary. J of Hypertens. 2006;24:1729–35.CrossRef
21.
go back to reference McManus RJ, Wood S, Bray EP, Glasziou P, Hayen A, Heneghan C, et al. Self-monitoring in hypertension: a web-based survey of primary care physicians. J Hum Hypertens. 2014;28:123–7.CrossRef McManus RJ, Wood S, Bray EP, Glasziou P, Hayen A, Heneghan C, et al. Self-monitoring in hypertension: a web-based survey of primary care physicians. J Hum Hypertens. 2014;28:123–7.CrossRef
22.
go back to reference Cuspidi C, Meani S, Lonati L, Fusi V, Magnaghi G, Garavelli G, et al. Prevalence of home blood pressure measurement among selected hypertensive patients: results of a multicenter survey from six hospital outpatient hypertension clinics in Italy. Blood Press. 2005;14:251–6.CrossRef Cuspidi C, Meani S, Lonati L, Fusi V, Magnaghi G, Garavelli G, et al. Prevalence of home blood pressure measurement among selected hypertensive patients: results of a multicenter survey from six hospital outpatient hypertension clinics in Italy. Blood Press. 2005;14:251–6.CrossRef
24.
go back to reference Viera AJ, Cohen LW, Mitchell CM, Sloane PD. Use of home blood pressure monitoring by hypertensive patients in primary care: survey of a practice-based research network cohort. J Clin Hypertens (Greenwich). 2008;10:280–6.CrossRef Viera AJ, Cohen LW, Mitchell CM, Sloane PD. Use of home blood pressure monitoring by hypertensive patients in primary care: survey of a practice-based research network cohort. J Clin Hypertens (Greenwich). 2008;10:280–6.CrossRef
25.
go back to reference Mejzner N, Clark CE, Smith LF, Campbell JL. Trends in the diagnosis and management of hypertension: repeated primary care survey in south West England. Br J Gen Pract. 2017;67:306–13.CrossRef Mejzner N, Clark CE, Smith LF, Campbell JL. Trends in the diagnosis and management of hypertension: repeated primary care survey in south West England. Br J Gen Pract. 2017;67:306–13.CrossRef
26.
go back to reference Liyanage-Don N, Fung D, Phillips E, Kronish IM. Implementing home blood pressure monitoring into clinical practice. Curr Hypertens Rep. 2019;21:14.CrossRef Liyanage-Don N, Fung D, Phillips E, Kronish IM. Implementing home blood pressure monitoring into clinical practice. Curr Hypertens Rep. 2019;21:14.CrossRef
27.
go back to reference Logan AG, Dunai A, McIsaac WJ, Irvine MJ, Tisler A. Attitudes of primary care physicians and their patients about home blood pressure monitoring in Ontario. J Hypertens. 2008;26:446–52.CrossRef Logan AG, Dunai A, McIsaac WJ, Irvine MJ, Tisler A. Attitudes of primary care physicians and their patients about home blood pressure monitoring in Ontario. J Hypertens. 2008;26:446–52.CrossRef
28.
go back to reference Fletcher BR, Hinton L, Bray EP, Hayen A, Hobbs FR, Mant J, et al. Self-monitoring blood pressure in patients with hypertension: an internet-based survey of UK GPs. Br J Gen Pract. 2016;66:e831–7.CrossRef Fletcher BR, Hinton L, Bray EP, Hayen A, Hobbs FR, Mant J, et al. Self-monitoring blood pressure in patients with hypertension: an internet-based survey of UK GPs. Br J Gen Pract. 2016;66:e831–7.CrossRef
29.
go back to reference Vaïsse B, Mourad J-J, Girerd X, Hanon O, Halimi J-M, Pannier B, et al. Flash survey 2012: the use of self-measurement in France and its evolution since 2010. Ann Cardiol Angeiol (Paris). 2013;62:200–3.CrossRef Vaïsse B, Mourad J-J, Girerd X, Hanon O, Halimi J-M, Pannier B, et al. Flash survey 2012: the use of self-measurement in France and its evolution since 2010. Ann Cardiol Angeiol (Paris). 2013;62:200–3.CrossRef
30.
go back to reference Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–36.CrossRef Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–36.CrossRef
31.
go back to reference Humbert X, Fedrizzi S, Touzé E, Alexandre J, Puddu P-E. White-coat hypertension: management and adherence to guidelines by European and Canadian GPs. BJGP Open: A cross-sectional clinical vignette study; 2019. Humbert X, Fedrizzi S, Touzé E, Alexandre J, Puddu P-E. White-coat hypertension: management and adherence to guidelines by European and Canadian GPs. BJGP Open: A cross-sectional clinical vignette study; 2019.
32.
go back to reference Martín-Rioboó E. Pérula de Torres LA, Banegas JR, lobos-Bejarano JM, Brotons Cuixart C, García Criado EI, et al. knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain: the MAMPA study. J Hypertens. 2018;36:1051–8.CrossRef Martín-Rioboó E. Pérula de Torres LA, Banegas JR, lobos-Bejarano JM, Brotons Cuixart C, García Criado EI, et al. knowledge, availability, and use of ambulatory and home blood pressure monitoring in primary care in Spain: the MAMPA study. J Hypertens. 2018;36:1051–8.CrossRef
33.
go back to reference Omboni S, Sala E. The pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring. Expert Rev Cardiovasc Ther. 2015;13:209–21.CrossRef Omboni S, Sala E. The pharmacist and the management of arterial hypertension: the role of blood pressure monitoring and telemonitoring. Expert Rev Cardiovasc Ther. 2015;13:209–21.CrossRef
34.
go back to reference Himmelfarb CRD, Commodore-Mensah Y, Hill MN. Expanding the role of nurses to improve hypertension care and control globally. Ann Glob Health. 2016;82:243–53.CrossRef Himmelfarb CRD, Commodore-Mensah Y, Hill MN. Expanding the role of nurses to improve hypertension care and control globally. Ann Glob Health. 2016;82:243–53.CrossRef
Metadata
Title
Home blood-pressure measurement for the diagnosis and monitoring of arterial hypertension by French general practitioners: a cross-sectional survey in the Auvergne region
Authors
Mangiavillano Xavier
Tréfond Jéromine
Plaquevent-Hostache Guillaume
Tanguy Gilles
Bœuf-Gibot Sylvaine
Mulliez Aurélien
Vorilhon Philippe
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-020-01358-9

Other articles of this Issue 1/2021

BMC Primary Care 1/2021 Go to the issue