APH 2002, 60, 385-396:

Doctor-patient agreement in the appreciation of arterial hypertension severity.

H. Ghannem, A. Ben Abdelaziz, Z. Bouabid, I. Harrabi, R. Gaha

Keywords: patient compliance, hypertension, perception, health education, patient-doctor agreement

Good compliance to antihypertensive therapeutic regimens is mainly related to a good patient-doctor relationship that permits adequate informing of a hypertensive patient about his disease and his treatment. In order to assess patient-doctor level of agreement concerning the appreciation of the severity of hypertension, we undertook a study of all hypertensive patients in the health centers at Kalaa Kebira (Sousse, Tunisia). The severity of hypertension was assessed objectively by the doctors using clinical criteria and subjectively by the patients perceptions. The arterial high blood pressure was considered grave by the doc tors for 53% of hypertensive patients. 58% of hypertensive patients perceived their state of health as dangerous. However, in regard to the gravity of the arterial high blood pressure, Kappa was equal to 0.0099 which points at discordance among doctors and patients. Moreover, the patients whose perception of their arterial high blood pressure gravity was in accordance to their regular GP s appreciation had a better ther apeutic compliance. The total doctor-patient discordance reflects the necessity for the development of health aimed at hypertensive patients: an essential constituent of any programme of control of hypertension and of the fight against cardiovascular diseases.