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Hypertension is one of the top ten diseases diagnosed and followed up in Family Medicine practice. 20 million office visits to Canadian family physicians and internists annually are due to high blood pressure. Most of the hypertensive patients are treated and followed up by teams consisting of a family physician and a nurse in Canada, Israel and in UK. In Turkey, Family Medicine has been put into practice in various regions since 2003 and nationwide since 2010. In this study, one year records of a family health unit consisting of a family medicine specialist and family medicine nurse have been evaluated for hypertension to emphasize the role of family medicine for prevention and control of hypertension.
Applications and follow up records of registered hypertensive patients to a family health unit in Çankaya province of Ankara-Turkey between June 2012 and June 2013 were evaluated. The data were derived from the patient records of the Family Physician (FP) recorded through Family Health Information System (FHIS). Since the records of FHIS based on ICD-10 (International Statistical Classification of Diseases and Related Health Problems) coding and the medications are included in the current pharmaceutical list of the Ministry of Health, the codes I10 Essential (primary) hypertension and I25 Chronic ischemic heart disease codes were taken for the evaluation.
Of the total 3812 registered population to the FP between June 2012 and June 2013, 1589 (42%) were males and 2223 (58%) were females and 881 people (23%) were over 65 years. Total of 12.379 office visits were performed between the dates 01.06.2012 and 01.06.2013 and 3736 of these office visits (1344 males and 2392 females) were admissions of hypertensive and/or hypertension comorbid patients. The most common comorbidities were chronic ischemic heart disease, Diabetes Mellitus and osteoarthritis consequently. Of the 85% of the patients home care visits were provided by FP or FP nurse in one year were hypertensive and/or hypertensive comorbid patients, mostly bedridden, immobile and old patients and of the 95% of the medication use reports given by FP were for antihypertensive medications and/or comorbid diseases mostly for Diabetes Mellitus.
About half of the FP office admissions are hypertensive and chronic ischemic heart disease patients. Family medicine health services are free of charge, currently each individual is registered to a FP in Turkey and Family Health Centers are easy to reach and commonly the closest health care facilities to the people where they reside. This is particularly important for older individuals to reach a health care service or home care services provided by FPs. Family physicians and nurses are crucial to prevent, control and follow up hypertension by helping their patients for modifiable risk factors, early diagnosis of hypertension, providing continuous treatment and are easily accessible by patients.