J Clin Outcomes Manage
A multifaceted intervention to improve blood pressure control in a community-based primary care practice
Cohen KR, Maier DE, Walters RS, Sanders TJ
Abstract Objective: To describe results of a multifaceted improvement intervention to improve blood pressure control among patients in a primary care group practice. Methods: We implemented a multifactorial intervention that included performance reporting, clinical and patient education, and financial performance incentives. Blood pressure control was assessed and compared with levels recommended in national guidelines. Results: In 2008, the overall level of blood pressure control to < 140/90 mm Hg was 66% of patients. Among patients with diabetes, 65% were controlled; among patients with chronic kidney disease, 40% were controlled. Among patients with congestive heart failure, 52% were controlled to the American College of Cardiology target of < 120/80 mm Hg. Control of blood pressure was 74% and 61% among patients of internal medicine physicians and family practice physicians, respectively (x2 = 14.185, P < 0.001). Conclusion: Following a multifaceted educational and quality improvement intervention, we found that levels of blood pressure control improved in average-risk patients. In addition, subpopulations of patients with diabetes, chronic kidney disease, and congestive heart failure had favorable levels of control. This approach is easily exportable to other physician organizations to improve outcomes by reducing cardiovascular disease morbidity and mortality.
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