Preference, Awareness, and Use of Sphygmomanometers in the Mercury-Free Era: A Cross-Sectional Survey of Physicians in Korea.

Physician preference for mercury sphygmomanometers declined but remained notable after the mercury ban.

• Preference for mercury sphygmomanometers shifted from 28.2% before the ban to 12.8% after the ban.
• 12.8% of physicians continued to use mercury sphygmomanometers even after the ban.
• The survey included 1,728 physicians with a 98.9% response rate.
• Physicians surveyed were from five specialties: cardiology (9.3%), internal medicine excluding cardiology (27.5%), family medicine (16.1%), general practice (21.6%), and other specialties (34.5%).

Preferences for mercury-free blood pressure devices increased following the mercury ban.

• Preference for aneroid devices increased from 13% to 17.4% after the ban.
• Preference for hybrid devices increased from 12.6% to 14.5% after the ban.
• Preference for automated devices increased from 46.2% to 55.3% after the ban.
• Automated devices were the most preferred device type both before and after the ban.

Physician awareness of mercury-free blood pressure devices was suboptimal.

• Only 50.3% of physicians had above-average awareness of mercury-free devices.
• Awareness was assessed via an online survey containing 31 items covering preferences, awareness of alternative BP devices, and compliance with standardized BP measurement protocols.
• The survey used a convenience sample design conducted online.

Compliance with standardized blood pressure measurement protocols (Korean Society of Hypertension Guidelines) was high for some standards but notably lower for others.

• High compliance was observed for cuff placement (84.8%), pulse rate measurement (81%), and 5 minutes of rest before measurement (80.3%).
• Lower compliance was noted for duplicate BP measurements (59.5%), both-arm measurements (59.5%), and positional BP measurements (52.6%).
• Compliance was assessed as part of a 31-item survey instrument.

The study was conducted as a cross-sectional online survey of physicians across multiple specialties in Korea in the context of the Minamata Convention mercury reduction initiative.

• The Minamata Convention initiated global mercury reduction, leading to the phase-out of mercury sphygmomanometers as mercury-containing medical devices.
• The survey included 1,728 physicians with a 98.9% response rate.
• Five specialties were represented: cardiology, internal medicine excluding cardiology, family medicine, general practice, and other specialties.
• BP devices were categorized as mercury-based (mercury sphygmomanometers) or mercury-free (aneroid, hybrid, and automated devices).