What does this research mean for the field?

The Office-Based Guidelines Applied to Practice (Office-GAP) program, which includes physician training and patient activation, significantly improves blood pressure control at 6 months in patients with hypertension in federally qualified health centers. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 1, 2016MDM Policy & PracticeOpen Access

Blood Pressure Control in Hypertensive Patients in Federally Qualified Health Centers

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Why the study?

Does the Office-GAP shared decision-making program improve blood pressure control in low-income patients with hypertension and diabetes or CHD at federally qualified health centers?

Population

243 adults with coronary heart disease and/or diabetes mellitus receiving care at federally qualified health…

Comparison

Office-Based Guidelines Applied to Practice… vs Standard care at a control federally qualified…

Design

Cohort, Centers were allocated as intervention and control by tossing a coin.

Follow-up

12 months

Authors

AOAdesuwa OlomuQueen Elizabeth Hospital Birmingham NKNazia Naz S. KhanMichigan State University DTDavid TodemMichigan State University

Discussion

Member takes

Implication

Should not yet change practice; leaves open causal benefit of Office-GAP in randomized trials.

Structured PICO

Does the Office-GAP shared decision-making program improve blood pressure control in low-income patients with hypertension and diabetes or CHD at federally qualified health centers?

Population

243 adults (182 with hypertension) with coronary heart disease (CHD) and/or diabetes mellitus (DM) receiving care at federally qualified health centers (FQHCs). Mean age 55, 57% female, 38% Black, 38% White. Low-income population.

Intervention

Office-Based Guidelines Applied to Practice (Office-GAP) program, including physician training for shared decision making, a 90-120 minute patient activation group visit, and use of an Office-GAP decision checklist during primary care visits at 3 and 6 months.

Comparator

Standard care at a control federally qualified health center (no Office-GAP intervention).

Outcome

Change in proportion of patients reaching their blood pressure goal (systolic BP <140 mmHg or <130 mmHg in DM; diastolic BP <90 mmHg or <80 mmHg in DM) assessed by chart review at 3, 6, and 12 months.surrogate

Implementation of a shared decision-making and patient activation program (Office-GAP) in federally qualified health centers significantly improved 6-month blood pressure control among low-income patients with hypertension and diabetes or CHD.

Limitations

Only two FQHCs clinics were studied, limiting generalizability
Data were obtained from chart abstraction and surveys, dependent on the accuracy of medical records
Differences in baseline characteristics of patients in the intervention and control arms

Cite This Study

Olomu et al. (2016) studied this question.

synapsesocial.com/papers/6a195ec3fa25ab5db6d96c32 https://doi.org/10.1177/2381468316656010

Topics

Hypertension management

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Blood Pressure Control in Hypertensive Patients in Federally Qualified Health Centers

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Blood Pressure Control in Hypertensive Patients in Federally Qualified Health Centers

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

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Topics

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