Key result
Pragmatic blood pressure measurement in primary care differed significantly from standard guidelines, leading to a 16.7% misclassification rate in treatment decisions and erroneously starting 19.5% of patients on anti-hypertensive therapy.
Why the study?
Does pragmatic blood pressure measurement differ from standardized measurement and affect clinical decision-making in adult outpatients?
Population
60 adult outpatients, with or without hypertension, accessing primary care at a rural hospital in Swaziland…
Comparison
Pragmatic blood pressure measurement by a nurse… vs Standardized blood pressure measurement using a…
Design
Cross-sectional, Systematic random sample used for selection; order of…
Authors
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Highlights the clinical risk of over-treating hypertension based on routine clinic readings; leaves open.
Cross-Sectional (n=60)
Single-blind
No
Does pragmatic blood pressure measurement differ from standardized measurement and affect clinical decision-making in adult outpatients?
Effect estimate: Kappa 0.7 (95% CI 0.5-0.9)
p-value: p=<0.001
Pragmatic blood pressure measurement in primary care significantly deviates from standardized guidelines, leading to substantial clinical misclassification and erroneous initiation of anti-hypertensive therapy.
Mlawanda et al. (2014) conducted a cross-sectional in Hypertension (n=60). Pragmatic blood pressure measurement vs. Standard blood pressure measurement (mercury sphygmomanometer) was evaluated on Agreement in treatment decisions (pragmatic vs standard BP) (Kappa 0.7, 95% CI 0.5-0.9, p=<0.001). Pragmatic blood pressure measurement in primary care differed significantly from standard guidelines, leading to a 16.7% misclassification rate in treatment decisions and erroneously starting 19.5% of patients on anti-hypertensive therapy.
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