The adoption of hypertension reference framework: An investigation among primary care physicians of Hong Kong

PLoS One. 2018 Oct 9;13(10):e0205529. doi: 10.1371/journal.pone.0205529. eCollection 2018.

Abstract

Background: The Hong Kong Government released a Reference Framework (RF-HT) for Hypertension Care for Adults in Primary Care Settings since 2010. No studies have evaluated its adoption by primary care physicians (PCPs) since its release.

Aim: We aimed to evaluate the level of PCPs' adoption of the RF-HT and the potential barriers of its use in family practice.

Design and setting: A cross-sectional study was conducted by a self-administered validated survey among all PCPs in Hong Kong through various means.

Methods: We assessed the level of and factors associated with its adoption by multivariate logistic regression modelling.

Result: A total of 3,857 invitation episodes were sent to 2,297 PCPs in 2014-2015. We received 383 completed questionnaires. The average score of adoption was 3.43 out of 4.00, and 47.5% of PCPs highly adopted RF-HT in their daily consultations. Male practitioners (adjusted odds ratio [aOR] = 0.524, 95% CI = 0.290-0.948, p = 0.033) and PCPs of public sector (aOR = 0.524, 95% CI = 0.292-0.940, p = 0.030) were significantly less likely to adopt the RF-HT. PCPs with higher training completion or being academic fellow are more likely to adopt RF-HT than those who were "nil to basic training completion" (aOR = 0.479, 95% CI = 0.269-0.853, p = 0.012) or "higher trainee" (aOR = 0.302, 95% CI = 0.093-0.979, p = 0.046). Three most-supported suggestions on RF-HT improvement were simplification of RF-HT, provision of pocket version and promoting in patients.

Conclusion: Among PCP respondents, the adoption level of the RF-HT was high. These findings also highlighted some factors associated with its adoption that could inform targeted interventions for enhancing its use in clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Guideline Adherence*
  • Hong Kong
  • Humans
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Physicians, Primary Care*
  • Practice Guidelines as Topic*
  • Primary Health Care* / methods

Grants and funding

This study is funded by Health and Medical Research Fund of the Food and Health Bureau, HKSAR (Ref. No. 12131241).