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Treatment intentions of general practitioners regarding hypertension in the oldest old: a vignette study

机译：全科医师治疗高龄高血压的意图：小插图研究

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Background The recent literature has shown that the risk of hypertension in the old strongly depends on their physical abilities. However, it is unknown whether general practitioners (GPs) adapt their treatment strategies to the patient’s independence. This study was conducted to investigate the treatment intentions of GPs for patients aged 80 and older with hypertension in relation to the patients’ level of dependency. Methods A vignette study in Belgium. Flemish GPs ( n =?305) were invited, directly or indirectly, by email to fill out a questionnaire, consisting of nine cases (three themes). In each theme, the level of dependency gradually increased. Per case, a score depending on the GP’s treatment intention was calculated (range 0–3). The total score represented the ‘Intention to Treat Hypertension in Older Persons’ scale (ITHOP-scale). The difference between the score for robust patients and strongly dependent patients was calculated (delta score). Results The scores on the ITHOP scale showed a mean of 15.2?±?6.0. A significant difference in treatment intention was found between robust patients and strongly dependent patients. The delta score showed a mean of 1.7?±?1.8. Differences between the GPs were responsible for 75?% of the variance of the total score, and differences in the level of dependency did not influence the variance (G coefficient =0.82). The GP’s experience showed an inverse relationship to the total and the delta score. Conclusion Large differences in treatment intentions for hypertension in the very old exist between GPs, but the patient’s level of dependency is not responsible for these differences.
机译：背景技术最近的文献表明，老年人患高血压的风险在很大程度上取决于他们的身体能力。但是，全科医生（GP）是否根据患者的独立性调整治疗策略仍是未知的。这项研究的目的是调查80岁及以上高血压患者的全科医生治疗意愿与患者依赖程度的关系。方法在比利时进行小插图研究。通过电子邮件邀请弗拉芒语的GP（n =？305）来直接或间接填写9个案例（三个主题）的问卷。在每个主题中，依赖性程度逐渐提高。每种情况下，都会根据GP的治疗意图计算得分（范围0-3）。总分代表“老年人高血压治疗意向”量表（ITHOP量表）。计算健壮患者和高度依赖患者的得分之间的差异（增量得分）。结果ITHOP量表的平均得分为15.2±6.0。在健壮患者和强烈依赖患者之间发现治疗意向的显着差异。 δ得分显示平均为1.7±1.8。 GP之间的差异占总得分方差的75％，依存度的差异不影响方差（G系数= 0.82）。 GP的经验表明，总得分和差值得分成反比。结论GP之间在非常老的年龄段中，高血压的治疗意图存在很大差异，但患者的依赖程度并不构成这些差异的原因。

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