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

• Published in: PloS one 2018-10, Vol.13 (10), p.e0205529-e0205529
• Main Authors: Fang, Yuan, Wang, Harry H X, Liang, Miaoyin, Yeung, Ming Sze, Leung, Colette, Chan, Chun Hei, Cheung, Wilson, Huang, Jason L W, Huang, Junjie, Sit, Regina W S, Wong, Samuel Y S, Wong, Martin C S
• Format: Article
• Language: English
• Subjects: Adoption; Adults; Blood pressure; Cardiovascular disease; Health care; Hypertension; Medical personnel; Medicine; Medicine and Health Sciences; Patients; People and places; Physicians; Primary care; Public health; Public sector; Research and Analysis Methods; Territorial transfers; Training
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0205529

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. We aimed to evaluate the level of PCPs' adoption of the RF-HT and the potential barriers of its use in family practice. A cross-sectional study was conducted by a self-administered validated survey among all PCPs in Hong Kong through various means. We assessed the level of and factors associated with its adoption by multivariate logistic regression modelling. 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. 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.