03033nas a2200265 4500008004100000245014400041210006900185260001700254300001000271490000600281520219100287653002202478653003402500653002502534653001702559653001302576100001602589700001802605700001702623700002702640700001502667700001702682700001902699856004902718 2020 eng d00aDoctors’ Knowledge, Attitude and Objective Adherence with Hypertension Guidelines in Quetta, Pakistan: A Cross-sectional Analytical Study0 aDoctors Knowledge Attitude and Objective Adherence with Hyperten cJanuary 2021 a57-630 v63 a

Background: There is scarcity of published information about doctors’ knowledge, attitude and adherence with hypertension guidelines from Pakistan. Objectives: To evaluate doctors’ knowledge, attitude and objective adherence with the recommendations of Clinical Practice Guidelines (CPG) developed by American Society of Hypertension/International Society of Hypertension. Methods: This cross-sectional questionnaire-based study included 95 doctors from various health care facilities in Quetta, Baluchistan to evaluate doctors’ knowledge of and attitude towards guidelines. Physicians’ endearment with ASH/ISH (2014) guidelines was evaluated by the prescriptions they wrote to 1900 hypertensive individuals (20 prescriptions of each enrolled doctor). Data was analysed using SPSS 20. Results: 58.9% doctors had sufficient knowledge of guidelines. Doctors’ with specialization and consultants, doctors of age >35 years and who were in clinical practice for >5 years had significantly (p-value<0.05) greater knowledge and more guidelines adherent practices than their counterparts. There was a significant association between doctors’ knowledge and practice scores. (rs=0.758, p-value <0.001). Overall, doctors had positive attitudes towards guidelines. A total of 1385 (72.9%) prescriptions were judged guidelines adherent. In multivariate analysis, guidelines adherence had statistically significant positive association with the presence of any comorbidity (OR=2.804, p-value<0.001), heart failure (OR=5.101, p-value<0.001), chronic kidney disease (OR=2.384, p-value<0.001) and benign prostatic hyperplasia (OR=3.137, p-value=0.009) and negative association with diabetes mellitus (OR=0.265, p-value<0.001). Conclusion: Only 58.9% doctors were adequately aware of guidelines recommendations. A fair number of patients (72.9%) received guidelines adherent prescriptions. Doctors’ poor knowledge of guidelines preferred antihypertensive agents in diabetic hypertensive patients reflected in their practices.

10aDiabetes Mellitus10aDuration of clinical practice10aGuidelines adherence10aHypertension10aPakistan1 aKhan, Mirza1 aAhmed, Nafees1 aWahid, Abdul1 aKhan, Syed, Liaquat Al1 aKhan, Asad1 aAkbar, Zarka1 aBibi, Palwasha uhttps://www.jppcm.org/article/2020/6/4/57-63