Publication: Clinical audit of adherence to hypertension treatment guideline and control rates in hospitals of different sizes in Thailand
Issued Date
2021-04-01
Resource Type
ISSN
17517176
15246175
15246175
Other identifier(s)
2-s2.0-85099749786
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Clinical Hypertension. Vol.23, No.4 (2021), 702-712
Suggested Citation
Chaisiri Angkurawaranon, Kanokporn Pinyopornpanish, Supattra Srivanichakorn, Pattara Sanchaisuriya, Bang on Thepthien, Dusida Tooprakai, Elisha Ngetich, Albertino Damasceno, Michael Hecht Olsen, James E. Sharman, Renu Garg Clinical audit of adherence to hypertension treatment guideline and control rates in hospitals of different sizes in Thailand. Journal of Clinical Hypertension. Vol.23, No.4 (2021), 702-712. doi:10.1111/jch.14193 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78331
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Title
Clinical audit of adherence to hypertension treatment guideline and control rates in hospitals of different sizes in Thailand
Other Contributor(s)
Universidade Eduardo Mondlane
The Lancet
Lampang Hospital
Menzies Institute for Medical Research
Organisation Mondiale de la Santé
Syddansk Universitet
Khon Kaen University
Mahidol University
Holbæk Sygehus
University of Oxford Medical Sciences Division
Chiang Mai University
Community based Health Research and Development Foundation
The Lancet
Lampang Hospital
Menzies Institute for Medical Research
Organisation Mondiale de la Santé
Syddansk Universitet
Khon Kaen University
Mahidol University
Holbæk Sygehus
University of Oxford Medical Sciences Division
Chiang Mai University
Community based Health Research and Development Foundation
Abstract
A clinical audit of hospitals in Thailand was conducted to assess compliance with the national hypertension treatment guidelines and determine hypertension control rates across facilities of different sizes. Stratified random sampling was used to select sixteen hospitals of different sizes from four provinces. These included community (<90 beds), large (90–120 beds), and provincial (>120 beds) hospitals. Among new cases, the audit determined whether (i) the recommended baseline laboratory assessment was completed, (ii) the initial choice of medication was appropriate based on the patient's cardiovascular risk, and (iii) patients received medication adjustments when indicated. The hypertension control rates at six months and at the last visit were recorded. Among the 1406 patients, about 75% had their baseline glucose and kidney function assessed. Nearly 30% (n = 425/1406) of patients were indicated for dual therapy but only 43% of them (n = 182/425) received this. During treatment, 28% (198/1406) required adjustments in medication but this was not done. The control of hypertension at six months after treatment initiation was 53% varying between 51% in community and 56% in large hospitals (p <.01). The hypertension control rate at last visit was 64% but varied between 59% in community hospitals and 71% in large hospitals (p <.01). Failure to adjust medication when required was associated with 30% decrease in the odds of hypertension control (OR 0.69, 95% CI 0. 50 to 0.90). Failure to comply with the treatment guidelines regarding adjustment of medication and lost to follow-up are possible target areas to improve hypertension control in Thailand.