Adopting data-driven risk stratification and population health management techniques in safety-net settings can boost hypertension control and reduce care disparities.
Improving hypertension control is a high priority in healthcare. According to the researchers, controlling blood pressure (BP) rates in US hypertension patients could prevent 56,000 cardiovascular events, 13,000 deaths, and save the healthcare industry $4.5 billion annually.
Despite the broad availability of clinical guidelines, the team noted that over 40 percent of US patients have blood pressure rates above recommended goals.
These clinics mainly provide care to minorities and low-income patients, many of whom have disproportionately high rates of hypertension. The CDC reports that the condition is most prevalent in black males, and that black individuals are twice as likely to die from uncontrolled hypertension as whites are. The team adapted the KPNC hypertension control intervention and implemented the strategy in a network of 12 safety-net clinics to evaluate its impact on BP control rates, as well as its effects on racial and ethnic subgroups.
The adapted program consisted of four key elements, including a patient registry to identify chronic disease patients and highlight gaps in care and an evidence-based treatment intensification protocol.
The program also featured a standardized BP measurement protocol and BP check visits
In addition, the use of fixed-dose combination drugs increased from 11 percent to 14 percent at the pilot site, and from 10 to 13 percent at the other 11 organizations. This is an important improvement, the researchers noted, as fixed-dose combination medications are associated with better BP control and lower costs.
“Our findings can inform adoption of best practices to improve BP control at safety-net clinics which must play a pivotal role in achieving nation-wide improvements in BP control and reducing socioeconomic disparities in hypertension.”
Article by Jessica Kent
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