Factors Influencing the Management of Hypertension in Type 2 Diabetes

ABSTRACTOBJECTIVETo investigate the factors that influence the management of hypertension in patients with type 2 diabetes in a family practice setting.METHODSThis was a qualitative study with a descriptive quantitative phase. In the quantitative phase, data were abstracted from the medical records of 50 randomly selected patients in 2 family medicine clinics. In the qualitative phase, individual interviews were conducted with 5 physicians and 7 patients.RESULTSSeventy percent of patients with type 2 diabetes were diagnosed with hypertension. Of those, the most recent blood pressure (BP) measurement was elevated for 57%. Qualitative analysis described discrepancies between patient and physician opinions regarding the inconvenience of frequent visits, objections to polypharmacy and preference for lifestyle modifications in initial management.CONCLUSIONMore effort is needed to lower BP in patients with type 2 diabetes. Physicians could improve the care of these patients by soliciting their views on common areas of misunderstanding related to the management of hypertension in type 2 diabetes.

RÉSUMÉOBJECTIFEtudier les facteurs qui influencent le traitement de l'hypertension chez des patients atteints de diabete de type 2 de cliniques de medecine familiale.MÉTHODESCette etude etait qualitative et comportait une phase quantitative descriptive. Au cours de la phase quantitative, les donnees ont ete extraites des dossiers medicaux de 50 patients choisis au hasard dans deux cliniques de medecine familiale. Au cours de la phase qualitative, on a interviewe separement 5 medecins et 7 patients.RÉSULTATSSoixante-dix pour cent des patients atteints de diabete de type 2 souffraient aussi d'hypertension. Chez 57 % de ces patients, la plus recente mesure de la pression sanguine etait elevee. L'analyse qualitative a revele des differences entre l'opinion des patients et celle des medecins en ce qui a trait aux inconvenients que constituent les visites frequentes, aux objections a la polypharmacie et a la preference pour des modifications du mode de vie comme mesure initiale.CONCLUSIONIl faut faire plus d'efforts pour reduire la pression sanguine chez les patients atteints de diabete de type 2. Les medecins pourraient ameliorer les soins de ces patients en leur demandant leur avis sur les malentendus courants ayant trait au traitement de l'hypertension en presence de diabete de type 2.