scholarly journals Blood pressure control rates measured in specialty vs primary care practices within a large integrated health system

2018 ◽  
Vol 20 (9) ◽  
pp. 1253-1259
Author(s):  
Sarah J. Billups ◽  
Joseph J. Saseen ◽  
Joseph P. Vande Griend ◽  
Lisa M. Schilling
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Health System ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Integrated Health ◽  
Care Practices ◽  
Primary Care Practices

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

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 Implementation of Patient and Family Advisory Councils in Primary Care Practices in a Large, Integrated Health System

2018 ◽  
Vol 34 (2) ◽  
pp. 190-191 ◽  
Author(s):  
Anita D. Misra-Hebert ◽  
Susannah Rose ◽  
Colleen Clayton ◽  
Kevin Phipps ◽  
Scott Dynda ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Advisory Councils ◽  
Integrated Health ◽  
Care Practices ◽  
Primary Care Practices

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.

Impact of Hypertension Guideline Implementation on Blood Pressure Control and Drug Use in Primary Care Clinics

1999 ◽  
Vol 25 (2) ◽  
pp. 68-77 ◽  
Author(s):  
Patrick J. O’Connor ◽  
Elaine S. Quiter ◽  
William A. Rush ◽  
Mark Wiest ◽  
Jeffrey T. Meland ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Drug Use ◽  
Blood Pressure Control ◽  
Guideline Implementation ◽  
Pressure Control ◽  
Primary Care Clinics ◽  
Hypertension Guideline

scholarly journals Predictors of Blood Pressure Control in Patients With Diabetes and Hypertension Seen in Primary Care Clinics

2005 ◽  
Vol 18 (6) ◽  
pp. 833-838 ◽  
Author(s):  
M DUGGIRALA ◽  
R CUDDIHY ◽  
M CUDDIHY ◽  
J NAESSENS ◽  
S CHA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Primary Care Clinics ◽  
Patients With Diabetes

Examining the Feasibility of a Simple Intervention to Improve Blood Pressure Control for Primary Care Patients

2016 ◽  
Vol 31 (4) ◽  
pp. 291-295
Author(s):  
Giang T. Nguyen ◽  
Heather A. Klusaritz ◽  
Alison O’Donnell ◽  
Elise M. Kaye ◽  
Heather F. de Vries McClintock ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Improve Blood Pressure Control ◽  
Primary Care Patients

Abstract P183: Minimal Impact of JAMA 2014 Guidelines on Blood Pressure Control in a Large Health System

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Alex R Chang ◽  
J E Hartle ◽  
Lawrence Appel ◽  
Morgan Grams
Keyword(s):  
Blood Pressure ◽  
Health System ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Mixed Effects Models ◽  
System Level ◽  
Minimal Impact ◽  
Before And After ◽  
Patients With Diabetes ◽  
Using Data

Background: JAMA 2014 blood pressure (BP) guidelines raised BP goals for adults older than 60 years (from <140/90 to <150/90) and adults with chronic kidney disease (CKD) or diabetes (from < 130/80 to <140/90). It is unknown whether there were changes in BP control at the health system level after guideline publication. Methods: Using data from 288,962 adults receiving primary care in the Geisinger Health System, we compared blood pressure control over 1-year time periods before and after the February 2014 publication of the JAMA 2014 BP guidelines (i.e. Aug 2012-July 2013 vs Aug 2014-July 2015). Mixed effects models were used, allowing intercepts to vary by individual, adjusted for age, gender, and race. Results: Mean age was 49.2 ± 18.3 y, 56.7% were female, and 2.5% were black. Prevalence of diagnoses for hypertension, diabetes, and CKD were 40.0%, 15.1%, and 11.4%, respectively. Overall, distributions of systolic BP were similar before and after JAMA 2014 BP guidelines (Figure). BP control <140/90 was also similar between the two periods for adults 18-59 y (90.9% vs. 90.3%; OR 1.01, 95% CI: 0.99-1.02; p=0.3), adults ≥ 60 y (81.8% vs 82.2%; OR 1.01, 95% CI: 1.00-1.03; p=0.05), and adults with diabetes (83.2% vs. 82.7%; OR 1.00, 95% CI: 0.99-1.02; p=0.7) whereas BP control <140/90 improved slightly for adults with CKD (81.7% vs. 82.1%; OR 1.06, 95% CI: 1.04-1.08; p<0.001). BP control <130/80 was marginally worse after JAMA 2014 BP guidelines in patients with diabetes (53.5% vs. 51.8%; OR 0.98, 95% CI: 0.96-0.99; p=0.01). Trends were similar in analyses only including patients with hypertension diagnoses (overall 78.6% vs. 78.2%, OR 1.00, 95% CI: 0.99-1.02; p=0.5), and when using a goal of < 130/80 for patients with CKD (53.3% vs. 53.5%; OR 1.06, 95% CI: 1.04-1.08; p<0.001). Conclusion: There was little change in blood pressure control in a large integrated health system after publication of the JAMA 2014 BP guidelines. These findings are reassuring given recent findings from the SPRINT trial supporting lower BP goals.

Sign in / Sign up

Export Citation Format

Share Document