General practitioners and internal medicine specialists in Sweden report hypertension practices that are closely related to each other and align with national guidelines, despite minor differences in specific drug class preferences.
Prescribing differences between GPs and specialists should not change practice; leaves open whether provider type influences hypertension outcomes.
OBJECTIVES: To study clinical practice and attitudes in hypertension care amongst general practitioners (GPs) and hospital internal medicine specialists. DESIGN: Mailed case report questionnaires. SUBJECTS: Ninety GPs and 69 internal medicine specialists at randomly selected primary health care centres and hospital outpatient departments. MAIN OUTCOME MEASURES: Case-bound treatment preferences, treatment goals and return visit planning, and views on factors influencing practice. RESULTS: The participation rate was 84% and 70%, for GPs and internal medicine specialists, respectively. GPs more often proposed nonpharmacological therapy (P < 0.05), solely and as a complementary treatment, and prescribed more calcium antagonists (P < 0.001), whilst internal medicine specialists prescribed more ACE inhibitors (P < 0.001). Personal experience guides practice more than national consensus and economy, more so with increasing time since specialization. CONCLUSIONS: GPs and internal medicine specialists in Sweden report a hypertension practice closely related to each others' and to the intentions of national guidelines.
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Mats Ribacke (1995) studied this question.
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