Key result
A multifaceted quality improvement intervention did not significantly improve blood pressure control in elderly Medicare patients with hypertension (42% vs 39% at baseline; P=0.24).
Why the study?
Does a multifaceted QIO intervention improve blood pressure control and use of recommended therapies in elderly Medicare patients with hypertension?
Observational (n=1,137)
Yes
Does a multifaceted QIO intervention improve blood pressure control and use of recommended therapies in elderly Medicare patients with hypertension?
A multifaceted quality improvement intervention for primary care physicians failed to significantly improve blood pressure control in elderly Medicare patients with hypertension.
Answers are grounded in this paper and cite their sources.
Caution against broad QI adoption for hypertension in elderly Medicare patients; leaves open whether refined interventions might succeed.
Qualidigm, the Connecticut Quality Improvement Organization (QIO), collaborated with 17 primary care physicians (PCPs) in private practice to improve the care of elderly patients with hypertension. Patients were identified from Medicare billing data and care was assessed from medical records. Improvement interventions included feedback of baseline performance data and provision of a variety of practice enhancing materials. Care was assessed for 590 patients in 1997 (16-47 patients/PCP) and 547 patients in 1999 (7-51 patients/PCP). Patient characteristics were similar in both periods. Use of recommended therapies and blood pressure control, ie, percent < 140/90 mm Hg, was low and did not improve significantly between the 2 periods (aggregate 39% in 1997 versus 42% in 1999; P = .24). Care of elderly patients with hypertension was not improved with a multifaceted QIO intervention. Additional study is required to determine incentives, barriers, and facilitating factors for quality improvement in the private practice primary care setting.
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Meehan et al. (2004) conducted an observational in Hypertension (n=1,137). Multifaceted QIO intervention (feedback of baseline performance data and practice enhancing materials) vs. Baseline care (1997) was evaluated on Blood pressure control (< 140/90 mm Hg) (p=.24). A multifaceted quality improvement intervention did not significantly improve blood pressure control in elderly Medicare patients with hypertension (42% vs 39% at baseline; P=0.24).
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