Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management

Background/Objectives : Pediatric hypertension is an important and impactful condition. The 2017 American Academy of Pediatrics clinical practice guidelines provide recommendations for identifying and managing this condition within primary care. However, the perspectives and self-described practices of physicians are largely absent in the current evidence base. We aim to fill this gap through our qualitative investigation of physicians' perceptions and practices related to the screening, follow-up, and management of primary pediatric hypertension. Methods : We conducted semi-structured interviews with pediatric and family medicine physicians from the largest healthcare system in central Massachusetts. The interviews explored physicians' perceptions, and practices related specifically to pediatric blood pressure screening, follow-up for high blood pressures, and management of primary hypertension. We used rapid qualitative analysis to synthesize data into the resulting themes. Results : Eleven interviews were conducted. Resulting themes included: (1) physicians are generally concerned about pediatric hypertension and familiar with guidelines, but other concerns often take precedence, (2) blood pressure screening occurs mainly during yearly well visits, (3) physicians do not trust high blood pressure readings, (4) follow-up after high blood pressure readings varies, and (5) primary care physicians typically refer to specialists for hypertension management. Conclusions : This study expands current literature by providing salient context to the state of pediatric blood pressure screening, follow-up, and primary hypertension management after the 2017 guidelines among primary care physicians affiliated with an academic medical center. Our findings related to physicians' trust in electronic health record flags and the utility of follow-up by school nurses warrant further investigation

Blood pressure · Family medicine · Intensive care medicine · Primary care · Blood Pressure and Hypertension Studies · Cardiac, Anesthesia and Surgical Outcomes · Medicine · Renal function and acid-base balance · Internal Medicine · Pediatrics

• Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

  Joseph T Flynn, David C Kaelber et al.•PEDIATRICS•2017

  Incluir item

• Population Research

  Open Access•Samuel J Stratton•Prehospital and Disaster Medicine•2021

  Incluir item

• Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis

  Open Access•Beck Taylor, Catherine Henshall et al.•BMJ Open•2018

  Incluir item

• Systematic methodological review

  Open Access•Hanna Kallio, Anna‐maija Pietilä et al.•Journal of Advanced Nursing•2016

  Incluir item

• Participant validation

  Open Access•Tor Slettebø•Qualitative Social Work•2021

  Incluir item

• Rapid Techniques in Qualitative Research

  Open Access•Cecilia Vindrola-Padros, G Ampah Johnson•Qualitative Health Research•2020

  Incluir item

• Sample sizes for saturation in qualitative research

  Open Access•Monique Hennink, Bruno Van Swinderen et al.•Social Science & Medicine•2022

  Incluir item

• Perspectives of Primary Care Clinicians on the Diagnosis and Treatment of Pediatric Hypertension

  Allison J Carroll, Nivedita Mohanty et al.•Family & Community Health•2023

  Incluir item

• Matrix Analysis as a Complementary Analytic Strategy in Qualitative Inquiry

  Open Access•Jennifer Bates Averill•Qualitative Health Research•2002

  Incluir item