Knowledge, perception, and practice of quebec health professionals regarding ambulatory and clinic blood pressure measurement methods

Objective: Hypertension Canada Guidelines recommend using standardized methods of blood pressure measurement (BPM), namely home (HBPM), ambulatory (ABPM), office (OBPM), and automated (AOBP) for hypertension management. Health professionals (HP), namely nurses, physicians, and pharmacists, routinely perform BPM, but their knowledge, perception, and practice concerning all methods is understudied, including in Canada, and results show critical gaps with the guidelines. This descriptive study is the first to establish a portrait primary care HP's in Quebec concerning the four BPM methods. Design and method: All licensed primary care HP's in Quebec were targeted. A validated and pretested investigator-initiated BPM questionnaire in English and French was used for data collection. In December 2019, physicians and pharmacists were recruited through their associations’ monthly newsletter, while nurses received a personalized email invitation with a link to a secured platform. UQTR issued the certificate of ethics. Results: A total of 453 nurses, 45 physicians, and 30 pharmacists participated in the study. The median age was 40 ± 11 years for nurses, 50 ± 13 years for physicians, and 42 ± 12 for pharmacists. The overall knowledge and perception scores for BPM methods are presented in Table 1. In practice, physicians frequently use HBPM for diagnostic purposes (73%), treatment (91%), and follow-up (86%), while HBPM was recommended by 47% of nurses and 53% of pharmacists. Overall, ABPM was used less frequently (<50% of the time) by all HP's. In the clinic, the auscultatory method is still used by a significant percentage of nurses (11%), physicians (32%) and pharmacists (7%), while only 25% nurses, 13% physicians and 30% pharmacists use the AOBP method. Conclusions: Overall, knowledge was suboptimal for nurses and somewhat optimal for physicians and pharmacists. Practice was unsatisfactory for all HPs. Training and continuing education should be encouraged and should be renewed with the newest education methods along with practice assessment.