Differences in the classification of hypertensive controlled patient in primary care: Cross sectional study

OBJECTIVES: To examine differences in blood pressure control using the 2006 National Institute for Health and Clinical Excellence (NICE) guidelines and the 2007 Quality and Outcome Framework (QOF) standards. DESIGN: Cross-sectional study. SETTING: 28 general practices located in Wandsworth, London. PARTICIPANTS: Hypertensive patients aged 17 years and over. MAIN OUTCOMES MEASURES: Percentage of hypertensive patients classified as a hypertensive controlled patient (HCP) by each standard. RESULTS: 79.5% of patients were classified as a HCP by the QOF target and 60.7% by the NICE target. 93% and 14% of practices had more than 70% of patients classified as a HPC by using the QOF and NICE targets respectively. By applying the QOF target, men aged 45-64 years and 65 years and over had significantly higher probability of being classified as a HCP compared to those aged 17-44 years, OR 1.34 (1.08-.165) and OR 2.15 (1.61-2.87) respectively. Regardless of the target, for men the probability of being classified as a HCP increased with age. CONCLUSION: Better achievement of blood pressure control targets is present when the less stringent QOF target is used. Men aged 65 years and over were more likely to be classified as a HCP. Greater consistency is needed between the clinical targets in QOF and NICE guidance.