Abstract Body: Introduction: Hypertension is the leading cause of death globally, yet little is known about how Armenian primary care providers (PCPs) manage the condition. This study measured the knowledge, attitude, practice, priority, and confidence of primary care providers (PCPs) in Armenia towards hypertension management.
Methods: A population-specific proportional sampling was conducted through a cross-sectional survey among PCPs in all ten predominantly rural provinces of Armenia. A World Hypertension League (WHL) questionnaire was adapted following the Armenian hypertension guidelines, and the sample size was adjusted to N=339 PCPs. These sections were included: (1) demographics of respondents; (2) knowledge of Armenian guidelines; (3) attitudes towards management; (4) current management practices; (5) priority toward management; and (6) confidence in performing clinical duties.
Results: Most providers reported following the Armenian or the European hypertension guidelines (90%). The PCPs' composite knowledge score of 46.4% (CI 44.9%–47.8%) was suboptimal, despite awareness of hypertension as a priority (97.6%). The composite scores highlighted moderate confidence (59.2%, CI 57.5-60.9) and attitude (53.6%, CI 52.1-55.0), strong practice (75.3%, CI 74.3-76.1), and high priority (93.1%, CI 92.5-93.7). Although 92% of PCPs indicated that their clinic has a registry of patients with hypertension, only 30% had confidence in using one. PCPs who participated in the USAID training program and who trained in internal medicine had nearly double the cumulative odds of having longer consultation times (OR = 1.89, 95% CI: [1.22, 2.93], p = 0.004) and (OR = 2.04, 95% CI: [1.26, 3.32], p = 0.004), respectively. About 68.4% of PCPs reported that shorter consultation times and patients’ inability to pay for treatment (73.7%) were common barriers to treatment. PCPs who completed internal medicine residencies had lower practice and priority scores than family medicine providers. PCPs near the capital had 88% lower odds of providing referrals compared to those in non-contiguous provinces (OR = 0.12, 95% CI: [0.07, 0.21], p < 0.001).
Conclusions: PCPs in Armenia prioritize hypertension and report desirable practices, but gaps in their knowledge, lifestyle counseling, and confidence in registry use remain. These findings underscore the need for additional provider training, policies to reduce identified barriers, and further studies to elucidate the reasons behind the “know-do” gap.