Key result
AMA MAP BP program implementation is linked to a ~12% absolute increase in hypertension control.
Why the study?
The study was conducted to attain 75% hypertension control and improve racial equity in control using the AMA MAP BP quality improvement program.
Does the AMA MAP BP quality improvement program improve hypertension control in adults seen in federally qualified health centers?
Observational (n=12,370)
Yes
Does the AMA MAP BP quality improvement program improve hypertension control in adults seen in federally qualified health centers?
Absolute Event Rate: 75.1% vs 63.6%
p-value: p=<0.0001
Implementation of a structured quality improvement program with a monthly dashboard and practice facilitation significantly improved hypertension control in federally qualified health centers, though racial disparities persisted.
May support QI program adoption in FQHCs; extends observational evidence but leaves causal effects open.
Objective: Attain 75% hypertension (HTN) control and improve racial equity in control with the American Medical Association Measure accurately, Act rapidly, Partner with patients blood pressure (AMA MAP BP™) quality improvement program, including a monthly dashboard and practice facilitation. Methods: Eight federally qualified health center clinics from the HopeHealth network in South Carolina participated. Clinic staff received monthly practice facilitation guided by a dashboard with process metrics (measure [repeat BP when initial systolic ≥140 or diastolic ≥90 mmHg; Act [number antihypertensive medication classes prescribed at standard dose or greater to adults with uncontrolled BP]; Partner [follow-up within 30 days of uncontrolled BP; systolic BP fall after medication added]) and outcome metric (BP <140/<90). Electronic health record data were obtained on adults ≥18 years at baseline and monthly during MAP BP. Patients with diagnosed HTN, ≥1 encounter at baseline, and ≥2 encounters during 6 months of MAP BP were included in this evaluation. Results: Among 45,498 adults with encounters during the 1-year baseline, 20,963 (46.1%) had diagnosed HTN; 12,370 (59%) met the inclusion criteria (67% black, 29% white; mean (standard deviation) age 59.5 (12.8) years; 16.3% uninsured. HTN control improved (63.6% vs. 75.1%, p<0.0001), reflecting positive changes in Measure, Act, and Partner metrics (all p<0.001), although control remained lower in non-Hispanic black than in non-Hispanic white adults (73.8% vs. 78.4%, p<0.001). Conclusions: With MAP BP, the HTN control goal was attained among adults eligible for analysis. Ongoing efforts aim to improve program access and racial equity in control.
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Behling et al. (2023) conducted an observational in Hypertension (n=12,370). AMA MAP BP quality improvement program vs. Baseline was evaluated on Hypertension control (BP <140/<90) (p=<0.0001). Implementation of the AMA MAP BP quality improvement program improved hypertension control from 63.6% at baseline to 75.1% (p<0.0001).
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