scholarly journals A multicomponent quality improvement intervention to improve blood pressure and reduce racial disparities in rural primary care practices

2016 ◽  
Vol 19 (4) ◽  
pp. 351-360 ◽  
Author(s):  
Crystal W. Cené ◽  
Jacqueline R. Halladay ◽  
Ziya Gizlice ◽  
Katrina E. Donahue ◽  
Doyle M. Cummings ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Racial Disparities ◽  
Quality Improvement Intervention ◽  
Rural Primary Care ◽  
Care Practices ◽  
Primary Care Practices ◽  
Improvement Intervention

Abstract 116: The Effect of a Practice-based Multi-component Intervention That Includes Health Coaching on Medication Adherence and Blood Pressure Control in Rural Primary Care

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Jia-Rong Wu ◽  
Doyle M Cummings ◽  
Quefeng Li ◽  
Jacquie Halladay ◽  
Katrina Donahue ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Medication Adherence ◽  
Mixed Effects ◽  
Health Coaching ◽  
Quality Improvement Intervention ◽  
Linear Mixed Effects ◽  
Rural Primary Care ◽  
Improvement Intervention

Background: Lower adherence to anti-hypertensive medications contributes to sub-optimal patient outcomes, yet there are few successful interventions in rural primary care that target improved adherence. The purpose of this study was to determine whether a multi-component quality improvement intervention that included literacy-sensitive health coaching with motivational interviewing was associated with improved medication adherence and reductions in blood pressure (BP) in patients with a history of uncontrolled hypertension (HTN). Methods: Adult patients in six rural primary care settings with one or more visits in the last year with a systolic BP > 150 mmHg were recruited. Project faculty facilitated systematic changes in care delivery in local practices. Patients also received monthly phone-based literacy-sensitive health coaching including a focus on medication adherence, and a BP cuff for home monitoring. Data regarding medication adherence (Morisky Medication Adherence Scale-8) and BP were collected at baseline, 6, 12, 18, and 24 months. Linear mixed effects modeling was used to determine the effects of the multi-component intervention on medication adherence and whether changes in medication adherence were associated with changes in systolic and diastolic BP. Results: There were 477 patients enrolled; the majority were female, black, and reported an annual household income of < $40,000. At baseline, 39% of the patients had low medication adherence (MMAS-8 score < 6). In linear mixed effects models, the intervention resulted in modest increases in medication adherence [5.75 ± 1.37 at baseline to 5.94 ± 1.33 at 24 months (p = .04)]. Corresponding changes in BP were: from 138.6 ± 21.8/81.6 ± 12.9 mmHg at baseline to 132.7 ± 19.5/76.1 ± 14.5 mmHg at 24 months follow-up [mean 0.22-0.25/0.24-0.26 mmHg per month before and after adjustment for covariates (p < .001)]. Changes in medication adherence were significantly associated with reductions in diastolic BP longitudinally (p = .047). Conclusion: A practice-based quality improvement intervention that includes health coaching is associated with improvements in medication adherence and BP, and offers promise as a clinically applicable intervention in rural primary care.

scholarly journals Assessing Quality Improvement Capacity in Primary Care Practices

2019 ◽  
Author(s):  
Michael Parchman ◽  
Melissa L. Anderson ◽  
Katie F Coleman ◽  
LeAnn Michaels ◽  
Linnaea Schuttner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Prior Experience ◽  
Pressure Control ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation. Methods: To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Results: The QICA score was associated with prior experience managing change and moderately associated with two of the three CQMs: aspirin use (r=0.16, p=0.049) and blood pressure control (r=0.18, p=0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. PFs notes provide examples of high scoring practices devoting time and attention to quality improvement whereas low scoring practices did not. Conclusions: The QICA is useful for assessing QI capacity within a practice and may serve as a guide for both facilitators and primary care practices in efforts to build this capacity and improve measures of clinical quality.

scholarly journals Assessing Quality Improvement Capacity in Primary Care Practices

2019 ◽  
Author(s):  
Michael Parchman ◽  
Melissa L. Anderson ◽  
Katie F Coleman ◽  
LeAnn Michaels ◽  
Linnaea Schuttner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Prior Experience ◽  
Pressure Control ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation. Methods: To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Results: The QICA score was associated with prior experience managing change and moderately associated with two of the three CQMs: aspirin use (r=0.16, p=0.049) and blood pressure control (r=0.18, p=0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. PFs notes provide examples of high scoring practices devoting time and attention to quality improvement whereas low scoring practices did not. Conclusions: The QICA is useful for assessing QI capacity within a practice and may serve as a guide for both facilitators and primary care practices in efforts to build this capacity and improve measures of clinical quality.

INTEGRATED PRIMARY CARE MENTAL HEALTH QUALITY IMPROVEMENT INTERVENTION

2016 ◽  
Vol 25 (12) ◽  
pp. 1010-1011 ◽  
Author(s):  
Joanne Cox ◽  
Hannah Durant ◽  
Natalie Castile ◽  
Sally Cheek ◽  
Katherine Dowd ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Quality Improvement ◽  
Integrated Primary Care ◽  
Quality Improvement Intervention ◽  
Primary Care Mental Health ◽  
Health Quality ◽  
Improvement Intervention

Implementing pharmacogenetic testing in rural primary care practices: a pilot feasibility study

2019 ◽  
Vol 20 (6) ◽  
pp. 433-446 ◽  
Author(s):  
Lynn G Dressler ◽  
Gillian C Bell ◽  
Pearl M Abernathy ◽  
Karl Ruch ◽  
Sheri Denslow
Keyword(s):  
Primary Care ◽  
Feasibility Study ◽  
Pharmacogenetic Testing ◽  
Rural Primary Care ◽  
Care Practices ◽  
Primary Care Practices ◽  
Pilot Feasibility Study

scholarly journals Blood Pressure Control in Hypertensive Patients in Irish Primary Care Practices

2009 ◽  
Vol 11 (8) ◽  
pp. 432-440 ◽  
Author(s):  
Brendan Buckley ◽  
Eamonn Shanahan ◽  
Niall Colwell ◽  
Eva Turgonyi ◽  
Peter Bramlage ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Hypertensive Patients ◽  
Care Practices ◽  
Primary Care Practices
Sign in / Sign up

Export Citation Format

Share Document