Awareness of hypertension guidelines among family physicians in primary health care

Background: Only 14% of patients on treatment achieve the recommended blood pressure target. Guidelines aim to assist clinicians in the management of patients with hypertension. Objectives: The primary purpose of the study was to survey family physicians(FPs) in Kuwait about their awareness, and to understand better their reasons for not implementing specific guidance within the WHO/ISH guidelines. Methods: This study is a cross-sectional survey that was carried out in the five health regions of Kuwait. All PHC physicians who were currently working as FPs were asked to participate in the study. Data were collected using a structured questionnaire of clinically oriented questions formulated on the basis of the 1999 World Health Organization/International Society of Hypertension (WHO/ISH), as standard reference. Results: The study revealed that 49.1% and 42.1% of FPs were very familiar or somewhat familiar with the guidelines respectively, 92.1% were in agreement, and 79.8% indicated that they always or usually follow these guidelines when treating patients. Regarding the correct choice of the guideline statements, only 8.8% of the FPs choose correctly less than ten of the 20 statements, 64% choose 10 to less than 15, and only 27.2% choose ≥15 statements. When asked about perceived patient barriers to blood pressure control, 84.0% of the respondents ranked overcrowded clinics as important or most important barrier to blood pressure control while, 87.4% considered lack of patient knowledge as important or most important barrier. Non availability of the drugs in the clinic was considered by 88.4% of the physicians, and poor adherence to antihypertensive drugs by 90.1%. Conclusion: There is a need to establish nationwide educational and quality monitoring programs to facilitate the correct implementation of hypertension guidelines in PHC clinical practices in Kuwait.