Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Wong KS (1), Ho KM (1), Li YC (1), Chen XRC(1)
Affiliation :
(1) Family Medicine and General Out-patient Clinics, Kowloon Central Cluster
Introduction :
ABPM services has been introduced to public General Outpatient Clinics (GOPCs) of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) since 2015. It assists in the diagnosis of HT in suspected hypertensive patients and monitoring of BP control in hypertensive patients. We aim to delineate the indications for ordering ABPM in GOPCs and to explore the patient characteristics and the results of the ABPM, so to enlighten family physicians on its proper application and interpretation in HT management.
Objectives :
To delineate the indications for ordering ABPM in public primary care setting and to explore patient characteristics and results of the ABPM.
Methodology :
Cross-sectional descriptive study. All patients who have had ABPM performed from 1/12/2016 to 30/11/2017 in five General Outpatient Clinics were included. The indications for performing the ABPM, demographics of patients undergoing ABPM and the results of ABPM were studied.
Result & Outcome :
There were 323 patients with ABPM done within the study period with valid results. 64% were female and 36% were male, and the average age was 64 ± 12 (19 to 94 years old). For the indications for ABPM, 150 (46%) were for establishing diagnosis of hypertension (HT) and 173 (54%) were for monitoring of blood pressure (BP) control among hypertensive patients.
More than one third (n=109, 34%) of primary care patients undergoing ABPM were found to have either white-coat HT or HT with white-coat effect. The use of ABPM might help avoid unnecessary initiation or escalation of antihypertensive drugs among these groups of patients. In addition, more than half of treated HT (n=98, 57%) patients undergoing ABPM were found to have suboptimal BP control, highlighting the important role of ABPM in the monitoring of BP control among HT patients.
Furthermore, more than half of patients (n=37, 56%) referred to ABPM with normal clinic BP were found to have masked HT or masked uncontrolled HT. Timely control of BP might prevent or delay the development of cardiovascular complications among this group of patients.
