Key result
Meeting HEDIS criteria for blood pressure control was achieved by 74% of patients and was associated with taking fewer antihypertensive drugs (p=0.023) and lower drug costs (p=0.016).
Why the study?
What factors influence blood pressure control and guideline compliance in a managed care population?
Observational (n=502)
Yes
What factors influence blood pressure control and guideline compliance in a managed care population?
A high percentage of managed care patients achieved target blood pressure, which was associated with fewer antihypertensive drugs and lower costs, though optimal management in diabetic patients remains challenging.
May support simpler regimens for BP control in managed care; leaves open causality and generalizability from this observational cohort.
We attempted to determine the percentage of patients meeting Health Plan Employer Data Information Set (HEDIS) criteria for blood pressure control (< or = 140/90 mm Hg), to identify factors contributing to differences in blood pressure control among those who met HEDIS criteria and those who did not, and to assess compliance with blood pressure management recommendations established by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) for diabetes mellitus and myocardial infarction. In this retrospective analysis, we randomly selected 502 patient records from three primary care clinics in southeast Michigan. All patients were commercial members of one health maintenance organization, 74% of whom met HEDIS criteria for blood pressure control. These patients took fewer blood pressure drugs throughout the year (p=0.023) and had lower antihypertensive drug costs than those who did not achieve HEDIS blood pressure goals (p=0.016). According to JNC-VI criteria, 46% of diabetic patients were at their blood pressure goal of below 130/85 mm Hg and 71.6% were managed with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Eighty-five percent of patients were taking beta-blockers after myocardial infarction. The percentage of patients achieving target blood pressure exceeded the national average and was associated with few antihypertensive drugs and low drug cost. Effective and appropriate management of blood pressure in people with diabetes remains a challenge.
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Romain et al. (2003) conducted an observational in Hypertension (n=502). Meeting HEDIS blood pressure goals vs. Not meeting HEDIS blood pressure goals was evaluated on Meeting HEDIS criteria for blood pressure control (<= 140/90 mm Hg). Meeting HEDIS criteria for blood pressure control was achieved by 74% of patients and was associated with taking fewer antihypertensive drugs (p=0.023) and lower drug costs (p=0.016).
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