Abstract: TH-PO437
Evaluating Blood Pressure Control in a VA Renal Clinic: A Performance Improvement (PI) Initiative
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention
Authors
- Ali, Maryyam, U of MN Renal Division, Minneapolis, Minnesota, United States
- Segal, Yoav, Minneapolis VAMC, Minneapolis, Minnesota, United States
- Malhotra, Ashish, Minneapolis VAMC, Minneapolis, Minnesota, United States
- Reule, Scott, Minneapolis VAMC, Minneapolis, Minnesota, United States
Background
The suboptimal control of hypertension in adult Americans highlights a major need for performance improvement activities at the practice level to achieve better blood pressure (BP) control and meet national benchmarks. We evaluated factors associated with poor BP control among hypertensives referred to our Veterans Administration Renal Clinic with the goal of defining potential correctable characteristics of the persistently hypertensive patient. This abstract presents the data of our baseline assessment - the essential first step in a PI initiative.
Methods
Study cohort: Veterans followed at the Renal Clinic in September 2017, including new consults and follow-up appointments.
Site: VA Health Care System, Minneapolis, Minnesota
Study Type: Retrospective, as a part of PI initiative
Methodology: Manual review of medical records beginning September 2017.
Patient follow-up: 3 months
Data recorded: Demography, co-morbidities and medications control of BP defined by JNC 8 guidelines as a core clinical metric, unless a different goal was documented by the provider.
Statistics: Chi-square analysis for unadjusted comparisons of patients by BP control and logistic regression for odds ratio (OR) calculations.
Results
A total of 105 veterans were included in the final study cohort. Compared to those not achieving goal BP (n = 55), those achieving BP goal (n = 50) had an average BP of 129/75 mmHg (vs. 151/82 mmHg) with a mean age of 68.2 years (vs. 69.8 years). The average medication number was 3.1 (vs. 2.4). Those not achieving BP goal during follow-up period were less likely to receive any intervention (43.6% vs. 68%; OR 0.36) and more likely to remain uncontrolled on subsequent clinic follow up (81.8% vs. 40%; OR 6.67). No significant differences by comorbidity or individual provider were observed.
Conclusion
Veterans not achieving BP goals in Renal Clinic were less likely to receive any intervention, a finding that did not vary by comorbidity. This data signifies a preliminary step to design future quality improvement interventions to identify high-risk groups and direct efforts to improve our population-level cardiovascular outcomes.