Skip to Main content Skip to Navigation
Journal articles

Implementation of home blood pressure monitoring among French GPs: A long and winding road

Abstract : Background To explore the perception of home blood pressure monitoring (HBPM) by general practitioners GPs) in everyday practice in order to identify facilitators and barriers to its implementation in daily practice. Methods A qualitative study comprising the conduct of six focus groups between October 2016 and February 2017, gathering 41 general practitioners in primary care practice in Lorraine (North Eastern France), with thematic and comprehensive analysis. Results The first reasons given by GPs to explain their difficulties with HBPM (Home Blood Pressure Monitoring) implementation were the usual lack of time, material and human resources. However, all of these motives masked other substantial limiting factors including insufficient knowledge regarding HBPM, poor adherence to recommendations on HBPM and fear of losing their medical authority. GPs admitted that HBPM use could enhance patient observance and decrease therapeutic inertia. Despite this observation, most GPs used HBPM only at the time of diagnosis and rarely for follow-up. One explanation for GP reluctance towards HBPM may be, along with guidelines regarding hypertension, HBPM is perceived as being a binding framework and being difficult to implement. This barrier was more predominantly observed among aging GPs than in young GPs and was less frequent when GPs practiced in multidisciplinary health centers because the logistical barrier was no longer present. Discussion In order to improve HBPM implementation in everyday practice in France, it is necessary to focus on GP training and patient education. We must also end "medical power" in hypertension management and turn to multidisciplinary care including nurses, pharmacists and patients.
Complete list of metadata

Cited literature [59 references]  Display  Hide  Download

https://hal.univ-lorraine.fr/hal-02936675
Contributor : Joëlle Kivits <>
Submitted on : Friday, September 11, 2020 - 3:27:01 PM
Last modification on : Thursday, January 14, 2021 - 4:20:03 PM
Long-term archiving on: : Friday, December 4, 2020 - 8:52:22 PM

File

journal.pone.0220460.pdf
Publisher files allowed on an open archive

Licence


Distributed under a Creative Commons Attribution 4.0 International License

Identifiers

Collections

Citation

Giselle Dugelay, Joëlle Kivits, Louise Desse, Jean-Marc Boivin. Implementation of home blood pressure monitoring among French GPs: A long and winding road. PLoS ONE, Public Library of Science, 2019, 14 (9), pp.e0220460. ⟨10.1371/journal.pone.0220460⟩. ⟨hal-02936675⟩

Share

Metrics

Record views

47

Files downloads

86