Key result
Mandatory health check-ups drive therapy modification in 100% of workers with abnormal BP visiting GPs.
Why the study?
Do mandatory periodic health check-ups improve compliance and reduce therapeutic inertia in workers with hypertension?
Cross-Sectional (n=1,010)
Do mandatory periodic health check-ups improve compliance and reduce therapeutic inertia in workers with hypertension?
Mandatory occupational health check-ups can effectively identify uncontrolled hypertension and prompt therapy modification by general practitioners, thereby reducing therapeutic inertia.
Mandatory worker screenings detect hypertension and drive therapy changes; extends guideline support for systematic occupational BP assessment.
BACKGROUND: Due to high prevalence, insufficient recognition, and ineffective treatment, hypertension (HT) still remains a major medical and socio-economic problem. There is a real necessity to develop effective prophylaxis for cardiovascular disorders (CVD), based on strategies that support compliance during long-term therapy. The Polish scheme of occupational health services with mandatory periodical employee check-ups creates a unique opportunity for effective HT prophylaxis. As a result, visiting a doctor is required not only due to health ailments but also by law, which is especially important for those feeling well. It enables an improvement in tertiary prevention, including actions taken not only by the doctors of the occupa-tional health services, but also by the physicians in charge of treating the patients. AIM: Evaluation of the usefulness of mandatory health check-ups of employees concerning frequency of diagnosis and im-provement of treatment outcomes of HT. METHODS: The study group comprised 1010 Polish workers referred by their employers for mandatory medical examinations. All of the study participants filled in a questionnaire focused on self-assessment of their health, current blood pressure (BP) mea-surements, and in cases where HT had been previously detected - compliance with medical recommendations. Then in the doctor's office BP measurements were taken twice. Workers who fulfilled a criterion indicating a need for intervention were educated on optimal diet, physical activity, and risk factors for CVD. They also received medical instructions for three-step action. The first recommendation: measure BP three times a day for one week and record the results. The second: visit a gen-eral practitioner (GP) for a professional assessment of those results. The third: re-visit the occupational health physician within three months. The criterion for intervention was prior HT and a mean of two BP measurements ≥ 180/110 mmHg - in each case, or ≥ 140/90 mmHg - in the case of occupational exposure to risk factors for CVD. RESULTS: The mean age of the study participants was 41.7 years (similar in both genders). A previous diagnosis of HT was declared by 20.1% of patients. 11% of patients involved in the intervention did not comply with medical advice. The current HT therapy of all of the subjects with HT (100% of those with abnormal BP, who visited their GP) was modified. CONCLUSIONS: Prophylactic medical check-ups of workers gives improved compliance and medical surveillance of HT in patients with an uncontrolled clinical course of this disease. Obligations and periodic examinations encourage both patients and physicians to improve compliance and reduce the risk of therapeutic inertia.
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Marcinkiewicz et al. (2018) conducted a cross-sectional in Hypertension (n=1,010). Mandatory health check-ups was evaluated on Frequency of diagnosis and improvement of treatment outcomes of hypertension. Mandatory health check-ups of workers identified prior hypertension in 20.1% of participants and resulted in therapy modification for 100% of those with abnormal blood pressure who visited a GP.
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