South African Family Practice

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Compliance with standard treatment guidelines in the management of hypertension: A review of practice of healthcare workers in Potchefstroom, North West Province, South Africa

Peter Rapula Siko, Claire van Deventer


Introduction: Hypertension is a leading lifestyle disease and major cause of morbidity and mortality in South Africa, and globally. Standard Treatment Guidelines are issued in this country to assist healthcare workers in the diagnosis and  management there of. Considering the debilitating effects caused by hypertension, the objectives were to find out whether healthcare workers diagnose and manage hypertension correctly in terms of compliance with the guidelines.
Method: A records audit was done of patients newly diagnosed with hypertension between April 2009 and March 2011 from a purposeful sample of clinics and the local hospital, using a data collection tool. The study included all adults above 18 years and excluded all patients with co-morbidity at the time of diagnosis.
Results: A total of 475 clinical encounters were analysed. Compliance with  diagnosis based on the clinical guideline was 56% and 75% by nurses and doctors respectively. Drug management by doctors was less adherent to guidelines (56.6%) than that of nurses (63.6%) There was overall poor compliance with non-drug management.
Conclusions: As the adherence to hypertension guidelines in primary care by  healthcare workers in general is suboptimal, continuous professional development in terms of diagnosis, drug and non-drug management is essential.

Keywords: clinical treatment guidelines, guideline compliance, healthcare workers, hypertension
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