Key result
Most specialist referrals for uncomplicated hypertension are inappropriate and conflict with guidelines.
Why the study?
A high proportion of referrals to hypertension specialists are inappropriate and do not match guideline criteria, indicating a gap in primary care management of uncomplicated hypertension.
Observational
A significantly high proportion of referrals to hypertension centers of excellence are inappropriate, suggesting primary care physicians often refer uncomplicated hypertension rather than managing it per guidelines.
High inappropriate referral rates for uncomplicated hypertension persist; hypothesis-generating on whether specialist availability drives primary care deferral.
In agreement with previous reports,6–8 our study defines a significantly high proportion of referrals as inappropriate and not matching guidelines’ criteria for referral. This suggests that many primary care physicians choose to refer patients with uncomplicated hypertension to a hypertension specialist, rather than undertaking or maintaining the management of the patient. This trend seems to have paradoxically increased since the introduction of the Hypertension Specialist and the indications for referral in the JNC 7 guidelines, thus suggesting that the general practioner is either unaware of or ignores the guidelines.
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S et al. (2012) conducted an observational in Hypertension. Referral to a hypertension specialist was evaluated on Appropriateness of referral. A significantly high proportion of referrals for uncomplicated hypertension to a specialist center were deemed inappropriate and inconsistent with guidelines.
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