Impact of Hypertension Guideline Implementation on Blood Pressure Control and Drug Use in Primary Care Clinics.
A worsening of blood pressure control has occurred in the 1990s despite the availability of sophisticated technologic, pharmacologic, and educational advances applicable to hypertension care.
Clinical guidelines that are intented to improve hypertension care by making specific recommendations on drug use, frequency of follow-up care, and target levels of blood pressure have been developed.
The Institute for Clinical Systems Integration's (ICSI's ; Minneapolis) Hypertension Treatment Guideline was developed in 1994 and is updated annually.
This study employed a quasi-experimental, before-and-after design at two medical groups to assess changes in the care provided to patients 18 years of age and older with identified hypertension (International Classification of Diseases-9 codes 401.0,401.1, or 401.9).
Among adults with hypertension, the proportion meeting the blood pressure goal of<140/90 mm Hg increased from 36.8% (of 685 patients) preguideline to 50.3% (of 928 patients) postguideline (chi-square=29.4, p<0.001) ; the mean arterial pressure decreased from 102.7 mm Hg to 99.4 mm Hg (t=5.45, p<0.001).
Cohort analysis of patients enrolled at both points in time confirmed these findings and showed an increase in the number of office visits from 5.4 to 6.7 visits per patient per year after guideline implementation (F=10.9, p=0.001). (...)
Mots-clés Pascal : Hypertension artérielle, Maladie, Prescription, Médecin, Pratique professionnelle, Recommandation, Adulte, Age, Population, Démographie, Pression artérielle, Coeur, Exploration, Amélioration, Processus, Méthodologie, Appareil circulatoire pathologie, Classe âge
Mots-clés Pascal anglais : Hypertension, Disease, Prescription, Physician, Professional practice, Recommendation, Adult, Age, Population, Demography, Arterial pressure, Heart, Exploration, Improvement, Process, Methodology, Cardiovascular disease, Age distribution
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 31/05/1999.