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

<b>Background/Objectives</b>: 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-d...

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Main Authors: Melissa Goulding, Grace W. Ryan, Elise M. Stevens, Sharina Person, Robert Goldberg, Arvin Garg, Stephenie C. Lemon
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/2/185
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author Melissa Goulding
Grace W. Ryan
Elise M. Stevens
Sharina Person
Robert Goldberg
Arvin Garg
Stephenie C. Lemon
author_facet Melissa Goulding
Grace W. Ryan
Elise M. Stevens
Sharina Person
Robert Goldberg
Arvin Garg
Stephenie C. Lemon
author_sort Melissa Goulding
collection DOAJ
description <b>Background/Objectives</b>: 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. <b>Methods</b>: 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. <b>Results</b>: 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. <b>Conclusions</b>: 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.
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spelling doaj-art-b0aea64e9a75495882e76f2c289776e02025-08-20T02:44:35ZengMDPI AGChildren2227-90672025-02-0112218510.3390/children12020185Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension ManagementMelissa Goulding0Grace W. Ryan1Elise M. Stevens2Sharina Person3Robert Goldberg4Arvin Garg5Stephenie C. Lemon6Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USADivision of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USADivision of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USADivision of Biostatistics and Health Services Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USADivision of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USADivision of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USADivision of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA<b>Background/Objectives</b>: 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. <b>Methods</b>: 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. <b>Results</b>: 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. <b>Conclusions</b>: 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.https://www.mdpi.com/2227-9067/12/2/185blood pressurepediatric hypertensionscreeningprimary careclinical practice guidelinesqualitative
spellingShingle Melissa Goulding
Grace W. Ryan
Elise M. Stevens
Sharina Person
Robert Goldberg
Arvin Garg
Stephenie C. Lemon
Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management
Children
blood pressure
pediatric hypertension
screening
primary care
clinical practice guidelines
qualitative
title Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management
title_full Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management
title_fullStr Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management
title_full_unstemmed Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management
title_short Pediatric Primary Care Physicians’ Perceptions of, and Processes for, Pediatric Blood Pressure Screening, Follow-Up, and Hypertension Management
title_sort pediatric primary care physicians perceptions of and processes for pediatric blood pressure screening follow up and hypertension management
topic blood pressure
pediatric hypertension
screening
primary care
clinical practice guidelines
qualitative
url https://www.mdpi.com/2227-9067/12/2/185
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