MANAGEMENT OF HIGH BLOOD PRESSURE IN MOROCCO:WHAT PLACE FOR RGMPS ?

Background:High blood pressure (HBP) is the main cardiovascular risk factor and a public health problem that is easy to recognize and treat. Therefore, good practice recommendations for treating hypertension in adults were developed in Morocco in 2012 as part of the ten recommendations of good medical practice (RGMPs). The objective of our study was to explore the degree of use of RGPMs for HBP among physicians in primary health care facilities (PHCFs). Methods:This mixed-methods exploratory study was based on the NHS* sustainability model. Physicians from 21 PHCFs in the Skhirat-Temara prefecture were interviewed using pretested questionnaires over a period of 6 weeks. We observed their practice in the management of HBP to assess the degree of application of RGMPs. The research strategy was based on a methodological triangulation validation technique. Quantitative data were analysed using Epi Info software version 7.2.2.6, and the significance of associations was determined using Students t test (significant if the P value˂0.05). The qualitative analysis consisted of a thematic content analysis of specific grids. Results:Fifty-eight questionnaires were completed, with a predominance of female participation. The average age was 48.60 years (±5.57 years) [3961] 83% worked in urban areas. The average age of seniority of function was 10 years (±5.61 years) [121]. Most participants (78%) had received continuing education on hypertension. Sixty-six percent were aware of RGMPs for HBP, but only 58% followed them. The total average degree of compliance with all recommendations was 73.27%. The statistical analysis revealed a significant difference in the degree of compliance between rural (79.72%) and urban (71.92%) areas (p=0.01) and among trained (75.44%) and untrained (65.73%) physicians (P=0.001). The main determinants related to their application were the adaptability and credibility of the RGMPs, information on and sharing of the recommendations, and staff training. Conclusions: Our study indicated that the degree of application of RGMPs in the management of hypertension by physicians in the PHCFs of the Skhirat-Témara prefecture is satisfactory and allowed us to make recommendations for action on the determinants of their proper application.