News in brief: Aussie BP control rates ‘unacceptably low’; CT coronary angiography not supported for suspected ACS; Patient communication suffers if physicians can’t multitask

Australia’s BP control rates “unacceptably low”

Australia’s blood pressure control rates “remain unacceptably low”, clinicians say.

A study that assessed 2,877 Australians’ blood pressure during May Measurement Month (MMM) 2019 found a third of patients had hypertension, only half of which, were aware of their condition.

Less than half (40%) of known hypertension patients were on antihypertensive medication and still 46% of those were inadequately treated (blood pressure > 140/90 mmHg), the authors wrote in the European Heart Journal.

Almost three quarters of treated patients were on a single anti-hypertensive medication.

While the MMM campaign “provides an important platform for standardised compilation of BP data and creation of BP awareness in Australia”, data from the 2019 campaign showed the nation’s BP control rates “remain unacceptably low” the authors concluded.

CT coronary angiography not supported for suspected ACS

Routine early CT coronary angiography is superfluous in intermediate risk patients with acute chest pain and suspected acute coronary syndrome, according to UK-based cardiologists.

A study of 1,748 patients with mean global registry of acute coronary events score of 115 showed CT coronary angiography did not affect death or myocardial infarction rates at one year (51% vs 53% on standard care alone, adjusted hazard ratio [HR]: 0.91, P = 0.65).

Nor did it affect coronary revascularisation, use of drug treatment for coronary syndrome or subsequent preventative treatments, the authors wrote in the British Medical Journal.

While patients undergoing the procedure were less likely to have invasive angiography (54.0% versus 60.8%, P = 0.001), their stays were somewhat longer than those receiving standard care (median increase from 2.0 to 2.2 days).

The findings “do not support the routine use of early CT coronary angiography in intermediate risk patients with acute chest pain and suspected acute coronary syndrome”, the authors concluded.

Patient communication suffers if physicians can’t mentally multitask

Patient communication tends to be less satisfactory in specialties in which physicians must use diagnostic reasoning during patient encounters, an Australian study has found.

Physicians have more ‘cognitive busyness’ and must mentally multitask more than specialists such as surgeons whose encounters are more focused on procedures, according to according to Queensland researchers who analysed communication ratings for 67 doctors across various specialties.

They said their findings suggested that patient communication may be relegated to a secondary task and the news of an adverse finding may be less well accepted from physicians than from a procedural specialist who was not distracted by cognitive multitasking.

Possible solutions included having separate consultations for making and conveying a diagnosis or taking a break during a consultation before delivering the diagnosis, they suggested in Internal Medicine Journal.

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