Arterial hypertension (AH) is the most important modifiable risk factor for morbidity and all-cause mortality worldwide [1]. It constitutes a major public health issue, particularly in low-resource countries [2][3]. Despite the availability of effective antihypertensive treatments, blood pressure control remains inadequate in a significant proportion of patients, exposing them to preventable cardiovascular complications [3]. Among the causes of poor blood pressure control are poor knowledge of the disease and therapeutic non-adherence [4].

The management of AH relies not only on the adoption of hygienic-dietetic measures and pharmacological treatment, but also on therapeutic adherence and the active involvement of the patient in managing their disease [1][3]. In this context, therapeutic patient education (TPE), as defined by the World Health Organization, aims to enable the patient to acquire the necessary skills to live as best as possible with a chronic disease [5]. By promoting a better understanding of AH, the action of medications, and hygienic-dietetic measures, it contributes to improving therapeutic adherence, blood pressure control, and, indirectly, to reducing the risk of cardiovascular complications [1][3][6].

The general practitioner, as the patient’s first point of contact with the healthcare system, plays a central role in the implementation of therapeutic patient education (TPE). However, in routine practice, TPE for hypertensive patients is often reduced to sporadic information, without a structured approach or clearly defined educational objectives. This confusion between information and therapeutic education can limit the effectiveness of the overall management of AH.

In sub-Saharan Africa, data on the knowledge and practices of general practitioners regarding TPE for hypertensive patients are scarce. In this context, an evaluation of these practitioners’ skills appears necessary in order to identify training needs and propose appropriate interventions.

This study is part of an action research approach. Its objective, in its diagnostic phase, was ti access the knowlege of general practitioners practicing in Libreville regarding TPE for hypertensive patients, in order to guide targeted training.

This study highlighted an overall insufficient level of knowledge in TPE among general practitioners practicing in Libreville, with no participant reaching a level of knowledge deemed good. These results are consistent with those reported in other African contexts, where deficiencies in knowledge and practices in the management of AH have also been described [8].

The knowledge deficiencies in TPE for hypertension observed among the general practitioners in this study may constitute a barrier to the effective implementation of this approach in routine practice. However, a properly structured TPE is associated with better therapeutic adherence and improved blood pressure control, key elements in the prevention of cardiovascular complications related to AH [4]-[6].

The frequent confusion between information, advice, and structured therapeutic education, observed in a significant proportion of physicians, indicates that they lack training in educational and behavioral techniques [9]. It underscores the need for specific and structured training. Informing the patient is not sufficient; TPE involves a pedagogical approach aimed at acquiring self-care and adaptation skills [5].

The low level of TPE training observed may explain the identified gaps, with nearly three-quarters of physicians reporting no specific training.

The knowledge deficiencies of practitioners have implications in clinical practice: several studies have shown that poor blood pressure control is closely linked to poor knowledge of the disease and therapeutic non-compliance [4][10]. Conversely, TPE has demonstrated its effectiveness in improving these determinants. It notably enables increasing the knowledge level of hypertensive patients, improving therapeutic adherence, and promoting better blood pressure control [6][11][12]. Furthermore, it has been established that a good level of patient knowledge is associated with better treatment adherence, while poor understanding of the treatment and its complications constitutes a factor of non-compliance [13]-[15].

The strength of this work lies in its integration into an action research approach. The diagnostic phase presented here allowed for the identification of concrete needs but also for proposing an educational intervention adapted to the local context. It led to the implementation of a TPE training workshop, as a part of the continuity of the action-research approach, without formal evaluation within the scope of the present study. This link between research and action represents a relevant lever for sustainably improving the management of hypertension.

This study has certain limitations. The principal is the small sample size. The use of voluntary online sampling may introduce selection bias, as the most motivated physicians are more likely to participate. Furthermore, the predominance of respondents working in hospital setting may limit the representativeness of the results for all general practiitioners in Libreville. Finally, since the data are self-reported, reporting bias cannot be excluded. These elements should be taken into account when interpreting and generalizing the results.

The knowledge of general practitioners on TPE for hypertension in Libreville is insufficient, with a persistent confusion between information and TPE. This diagnostic study, embedded in an action research approach, enabled the identification of training needs and the guidance of a targeted educational intervention. Strengthening the TPE skills of general practitioners appears essential for improving the prevention of cardiovascular complications related to arterial hypertension. Complementary studies would be useful to assess the impact of these strategies on professional practices and patient blood pressure control.