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Clinical audit of adherence to hypertension treatment guideline and control rates in hospitals of different sizes in Thailand

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Angkurawaranon, C, Pinyopornpanish, K, Srivanichakorn, S, Sanchaisuriya, P, Thepthien, B-o, Ngetich, E, Damasceno, A, Hecht Olsen, M, Sharman, JE ORCID: 0000-0003-2792-0811 and Garg, R 2021 , 'Clinical audit of adherence to hypertension treatment guideline and control rates in hospitals of different sizes in Thailand' , Journal of Clinical Hypertension, vol. 23, no. 4 , pp. 702-712 , doi: 10.1111/jch.14193.

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Abstract

A clinical audit of hospitals in Thailand was conducted to assess compliance with the national hypertension treatment guidelines and determine hypertension control rates across facilities of different sizes. Stratified random sampling was used to select sixteen hospitals of different sizes from four provinces. These included community (120 beds) hospitals. Among new cases, the audit determined whether (i) the recommended baseline laboratory assessment was completed, (ii) the initial choice of medication was appropriate based on the patient's cardiovascular risk, and (iii) patients received medication adjustments when indicated. The hypertension control rates at six months and at the last visit were recorded. Among the 1406 patients, about 75% had their baseline glucose and kidney function assessed. Nearly 30% (n = 425/1406) of patients were indicated for dual therapy but only 43% of them (n = 182/425) received this. During treatment, 28% (198/1406) required adjustments in medication but this was not done. The control of hypertension at six months after treatment initiation was 53% varying between 51% in community and 56% in large hospitals (p p < .01). Failure to adjust medication when required was associated with 30% decrease in the odds of hypertension control (OR 0.69, 95% CI 0. 50 to 0.90). Failure to comply with the treatment guidelines regarding adjustment of medication and lost to follow-up are possible target areas to improve hypertension control in Thailand.

Item Type: Article
Authors/Creators:Angkurawaranon, C and Pinyopornpanish, K and Srivanichakorn, S and Sanchaisuriya, P and Thepthien, B-o and Ngetich, E and Damasceno, A and Hecht Olsen, M and Sharman, JE and Garg, R
Keywords: Thailand, blood pressure control, clinical audit, clinical practice guidelines, hypertension
Journal or Publication Title: Journal of Clinical Hypertension
Publisher: Wiley Periodicals Inc.
ISSN: 1524-6175
DOI / ID Number: 10.1111/jch.14193
Copyright Information:

© 2020 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License, (https://creativecommons.org/licenses/by-nc/4.0/) which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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