Citation
Manoharan, Anusha and Ngee Ling, Beatrice Jee and Hazwan, Mat Din and Salbiah, Mohamed Isa and Norasnita, Nordin and Tan, Siow Foon and Ho, Bee Kiau
(2024)
Enhancing adherence to clinical practice guidelines for hypertension management: Evaluation of the effectiveness of a Hypertension Management Tool Kit (HMTK) among primary healthcare doctors. (ImprovBP-HMTK).
Clinical Epidemiology and Global Health, 28.
art. no. 101668.
pp. 1-6.
ISSN 2213-3984; eISSN: 2213-3984
Abstract
Introduction: Adherence to guidelines in managing hypertension among primary healthcare doctors remains suboptimal. Objective: We assessed the effectiveness of a Hypertension Management Tool Kit (HMTK) in improving guideline adherence. Methods: Medical records of 392 patients attending 2 primary care clinics in the Klang district with 3 or more anti-hypertensive medications were audited. Paired T-test and repeated measure ANOVA were used to evaluate the effectiveness of the HMTK intervention with the evaluation of interaction within-subject effects, between subject effect and time. Results: The mean MOGC score of doctors with <5 years of service was 79.765 (95 % CL 78.351,81.178) and with >5 years of service; 81.238 (95 % CI 80.621,81.855). Statistically significant (p-value <0.001) results were shown based on the time effect and mean MOGC score with HMTK; pre-intervention 72.426 (95%CI 71.045, 73.808) and post-intervention 88.576 (95 % CI 87.922, 89.230). The mean MOGC score post-intervention based on the time effect and years of service for both groups were statistically significant (p-value <0.001) and increment was shown in <5 years of service; 69.252 (14.915) to 87.149 (6.484) while >5 years of service; 73.485 (14.281) to 89.613 (5.149). Statistically significant was shown by years of service in time-group interaction effect pre- and post-intervention (p-value <0.001); pre-intervention for <5 years of service; 71.892 (95%CI 69.339,74.446) and >5 of service; 72.960 (95 % CI 71.895,74.075). Post-intervention in <5 years of service; 87.692 (95%CI 86.427,88.846) while >5 years of service; 89.516 (95%CI 88.987,90.044). Conclusion: The HMTK is an effective tool to improve the management of hypertension among doctors.
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