Implementation of Clinical Hypertension Guidelines and Single Pill Combinations: A Qualitative Study in Australian General Practice

作者：Sonali R Gnanenthiran, Isabella Tan, Miriam Pikkemaat, Mingjuan Zeng, C. Hespe, Markus P Schlaich, Anthony Rodgers, Aletta E Schutte · 发表于：American Journal of Hypertension · 年份：2026 · DOI：10.1093/ajh/hpag109 · 研究领域：Clinical practice guidelines implementation、Blood Pressure and Hypertension Studies、Health Policy Implementation Science

BACKGROUND: Hypertension is the leading cause of preventable deaths worldwide, yet blood pressure (BP) control remains poor in Australia when compared to other similar higher income countries. This study aims to explore general practitioners' (GPs) perceptions of hypertension management and single pill combination (SPC) to identify barriers and facilitators to guideline implementation and SPC use in Australia. METHODS: Semi-structured interviews were conducted with 20 GPs (June-July 2024). Participants were purposively sampled to ensure diversity (age, sex, experience, location). Interviews explored diagnosis, treatment, monitoring, and attitudes toward guidelines and single pill combinations (SPCs). Transcripts were analyzed using a combined deductive-inductive approach guided by the Consolidated Framework for Implementation Research. RESULTS: GPs demonstrated limited awareness of recent international guideline updates and relied predominantly on the 2016 Australian guidelines, with most initiating treatment with monotherapy and targeting BP < 140/90 mmHg. SPCs were rarely used early and were perceived as difficult to titrate. Practice-level audits of BP control were absent, team-based care was inconsistently implemented. Therapeutic inertia and non-adherence to antihypertensive therapy-key barriers to BP control-were rarely acknowledged. Younger and academically affiliated GPs were more receptive to SPCs and lower BP targets, while experienced GPs often favored conservative...