Exclusive: 45% of GPs ignore NICE hypertension guidance

Only half of GPs are exclusively following the NICE/British Hypertension Society (BHS) guidelines issued in June this year, a GP survey has shown.

The survey of 238 GPs revealed that while 94 per cent had started to use the latest hypertension guidelines, 45 per cent applied them in conjunction with older recommendations, including the Joint British Societies’ guideline (JBS2) and previous BHS guidance.

It also showed that 9 per cent of those using a combination of guidelines referred to local protocols.

RCGP chairman Professor Mayur Lakhani criticised this mix-and-match approach, saying it compromised patient safety.
‘I would be concerned if inadvertent pressure was being put on GPs by primary care organisations (PCOs) to deviate from NICE guidance, which is the gold standard,’ he said. ‘A true translation of the NICE guidance by PCOs for local implementation could be workable but must not deviate from the evidence base.’ Hertfordshire GP Professor Mike Kirby, a member of the Primary Care Cardiovascular Society (PCCS), said it was unwise to use old guidelines ‘because medical evidence moves on’.

‘The risk is that people will go on to use beta-blockers first line and we know they’re less effective than other drugs,’ he said.

Evidence has shown that beta-blockers give less protection against stroke than other agents and, when used with diuretics, are associated with a 50 per cent increased risk of diabetes.

The NICE/BHS guideline puts beta-blockers fourth line for uncomplicated hypertension rather than first line as before. But the GP survey found that a fifth of GPs disagreed with this decision.

Leeds GP Dr Mark Davis, who was on the NICE/BHS guideline development group said: ‘Using a beta-blocker is better than nothing. It is encouraging that the majority are giving consideration to these guidelines.’

PCCS chairman and North Yorkshire GP Dr Terry McCormack welcomed the 94 per cent uptake and said using a combination of guidelines was to be expected: ‘A guideline is just that. The best way to use it is to adapt it.’

A spokesman for NICE said: ‘It is important to emphasise that the review of the NICE guideline was limited to the pharmacological aspects of hypertension. There- fore it is not surprising that GPs will use some other guidance.’

rachel.liddle@haymarket.com

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

UK on course for 50,000 COVID-19 cases a day by mid-October

UK on course for 50,000 COVID-19 cases a day by mid-October

The UK could see 50,000 COVID-19 cases per day by mid-October, with the epidemic...

Stricter short-term COVID-19 measures needed to avoid second national lockdown, BMA warns

Stricter short-term COVID-19 measures needed to avoid second national lockdown, BMA warns

COVID-19 infection rates will ‘soar’ and the NHS will ‘once again be crippled’ if...

Practices handed one-month opt-out window as revamped network DES unveiled

Practices handed one-month opt-out window as revamped network DES unveiled

NHS England has unveiled a revamped DES package for 2020/21 confirming new targets,...

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered a huge increase in face-to-face appointments in the week before NHS...

RCGP facing legal action over stance on assisted dying

RCGP facing legal action over stance on assisted dying

The RCGP is facing legal action over its decision to remain opposed to assisted dying...

Medeconomics Live aims to help practices thrive under the new GP contract

Medeconomics Live aims to help practices thrive under the new GP contract

The one-day, virtual Medeconomics Live conference aims to provide practices with...