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Background: This study aimed to identify strategies to improve the management of hypertension in general practice., Methods: Four focus groups (25 general practitioners and general practice registrars) were conducted, recorded and transcribed. Common emerging themes were analysed by an iterative thematic process., Results: Four main themes were identified: uncertainty about blood pressure measurement, achieving consensus in practice, accommodating patient differences and addressing systematic barriers. General practitioners want a more standardised approach to measuring and interpreting blood pressure with consistent, valid readings taken on one device that accurately measures patients blood pressure in the 'real world'. General practitioners want to be upskilled in specific areas related to hypertension management., Discussion: To facilitate improvements in blood pressure management, the most pressing needs of this group of GPs is to reduce the uncertainty surrounding the measurement and interpretation of blood pressure readings. This study has identified that sections of existing hypertension guidelines need to be reviewed and implemented.

Clinical practice guidelines (CPGs) are a central technique within the evidence-based medicine (EBM) movement. General practice is an area of medicine that seems to be particularly resistant to the use of CPGs. This article contributes to the debates about GPs and CPGs by reflecting on three different Australian studies conducted by the authors in an attempt to better understand variations between GPs' practices and the recommendations found in relevant CPGs. These projects focused on dementia, chronic obstructive pulmonary disease and hypertension (high blood pressure). A common finding across the three studies was that GPs described how their focus on the whole person and their patients' priorities and needs meant that the recommendations found in CPGs were not always appropriate or easy to apply. In doing this, our study participants were describing tensions between the holistic/whole person and patient-centred approach of GPs and the narrow disease-specific focus of guidelines. Our work provides insight into the rationality of GPs and illustrates some of the ways that whole person care and patient-centred care create operational challenges to the application of EBM in the form of CPGs. [ABSTRACT FROM AUTHOR]