Background: Hypertension is a common medical condition but largely undiagnosed, untreated, poorly controlled, and undertreated in low- and middle-income countries. Studies have reported missed hypertension during triage in Emergency Departments; however, little is known about missed elevated blood pressure (EBP) during triage in primary care settings. This study assessed the prevalence and predictors of missed EBP among triaged patients attending General Outpatient Clinics in Northern Nigeria.
Methods: This was a descriptive cross-sectional multi-centre study involving 187 adults randomly selected from patients triaged in four General Outpatient Clinics in northern Nigeria. An investigator-administered questionnaire was employed to obtain data regarding participants' socio-demographic, triage blood pressure (BP) measurement, physician-led BP measurement, and physicians' clinical decision characteristics. Chi-square test and logistic regression analysis were used to determine factors associated with and predictors of missed EBP, respectively.
Results: Participants' mean age was 40.6±14.7years. They were predominantly females (122, 65.2%). EBP was missed in 28 (15%) participants at the triage. Participants' age (>40years) (Odds ratio [OR]=3.82, 95% Confidence interval [CI]=1.43-10.22, P=0.008), study site (OR=0.32, 95% CI=0.12-0.82, P=0.018) and perceived receipt of explanation on BP measurement procedure (OR=2.97, 95% CI=1.25-7.07, P=0.014) were predictors of missed EBP among participants.
Conclusion: The prevalence of missed EBP was low but remarkable because of its huge public health implications. Age, study site, perceived receipt of explanation on BP measurement procedure predicted missed EBP. Effective interventions are needed to curtail missed EBP in these and similar settings.
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