Improving the quality of blood pressure measurements in an outpatient diabetes clinic

Hypertension is an important modifiable risk factor for cardiovascular disease in patients with diabetes. Despite established guidelines, the percentage of patients meeting the target blood pressure (BP) of <140/90 mm Hg in clinic remains suboptimal. In this project, we sought to improve BP m...

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Autores principales:	Matthew Johnson, Jennifer Wyckoff, Jennifer J Iyengar, Shafaq Khairi, Jessica E Fennelly
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/cbb30f9b357c428493b1d08fcc12931e
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spelling	oai:doaj.org-article:cbb30f9b357c428493b1d08fcc12931e2021-11-11T06:30:08ZImproving the quality of blood pressure measurements in an outpatient diabetes clinic10.1136/bmjoq-2020-0009172399-6641https://doaj.org/article/cbb30f9b357c428493b1d08fcc12931e2021-01-01T00:00:00Zhttps://bmjopenquality.bmj.com/content/10/1/e000917.fullhttps://doaj.org/toc/2399-6641Hypertension is an important modifiable risk factor for cardiovascular disease in patients with diabetes. Despite established guidelines, the percentage of patients meeting the target blood pressure (BP) of <140/90 mm Hg in clinic remains suboptimal. In this project, we sought to improve BP measurement in an outpatient diabetes clinic.Two interventions were performed: (1) Changes were made to the timing of BP measurement during patient intake and (2) An electronic medical record (EMR) alert reminded staff to repeat BP if the initial reading was above target. Baseline data were collected on 4764 patients, with 72.5% meeting their BP target. After implementation of changes to the timing of BP measurement during patient intake, 73.3% of patients met the target (no significant change). However, after implementation of the EMR alert, there was a statistically significant improvement in patients meeting the target BP at 76.8% (p<0.01). This reduction was driven by the high percentage of patients with an initially elevated BP measurement that came down into goal range on repeat measurement. Those who remained above target despite multiple readings could be referred to a new pharmacist-led hypertension clinic to ensure adequate follow-up and medication adjustment.It is important to ensure that in clinic BP measurements are taken correctly and adhere to best practices. Use of a single in-clinic BP measurement may result in overtreatment of hypertension. While timing of BP measurement during patient intake was not important, repeating high BP measurements did improve the number of patients in an outpatient diabetes clinic meeting their BP target.Matthew JohnsonJennifer WyckoffJennifer J IyengarShafaq KhairiJessica E FennellyBMJ Publishing GrouparticleMedicine (General)R5-920ENBMJ Open Quality, Vol 10, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Matthew Johnson Jennifer Wyckoff Jennifer J Iyengar Shafaq Khairi Jessica E Fennelly Improving the quality of blood pressure measurements in an outpatient diabetes clinic
description	Hypertension is an important modifiable risk factor for cardiovascular disease in patients with diabetes. Despite established guidelines, the percentage of patients meeting the target blood pressure (BP) of <140/90 mm Hg in clinic remains suboptimal. In this project, we sought to improve BP measurement in an outpatient diabetes clinic.Two interventions were performed: (1) Changes were made to the timing of BP measurement during patient intake and (2) An electronic medical record (EMR) alert reminded staff to repeat BP if the initial reading was above target. Baseline data were collected on 4764 patients, with 72.5% meeting their BP target. After implementation of changes to the timing of BP measurement during patient intake, 73.3% of patients met the target (no significant change). However, after implementation of the EMR alert, there was a statistically significant improvement in patients meeting the target BP at 76.8% (p<0.01). This reduction was driven by the high percentage of patients with an initially elevated BP measurement that came down into goal range on repeat measurement. Those who remained above target despite multiple readings could be referred to a new pharmacist-led hypertension clinic to ensure adequate follow-up and medication adjustment.It is important to ensure that in clinic BP measurements are taken correctly and adhere to best practices. Use of a single in-clinic BP measurement may result in overtreatment of hypertension. While timing of BP measurement during patient intake was not important, repeating high BP measurements did improve the number of patients in an outpatient diabetes clinic meeting their BP target.
format	article
author	Matthew Johnson Jennifer Wyckoff Jennifer J Iyengar Shafaq Khairi Jessica E Fennelly
author_facet	Matthew Johnson Jennifer Wyckoff Jennifer J Iyengar Shafaq Khairi Jessica E Fennelly
author_sort	Matthew Johnson
title	Improving the quality of blood pressure measurements in an outpatient diabetes clinic
title_short	Improving the quality of blood pressure measurements in an outpatient diabetes clinic
title_full	Improving the quality of blood pressure measurements in an outpatient diabetes clinic
title_fullStr	Improving the quality of blood pressure measurements in an outpatient diabetes clinic
title_full_unstemmed	Improving the quality of blood pressure measurements in an outpatient diabetes clinic
title_sort	improving the quality of blood pressure measurements in an outpatient diabetes clinic
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/cbb30f9b357c428493b1d08fcc12931e
work_keys_str_mv	AT matthewjohnson improvingthequalityofbloodpressuremeasurementsinanoutpatientdiabetesclinic AT jenniferwyckoff improvingthequalityofbloodpressuremeasurementsinanoutpatientdiabetesclinic AT jenniferjiyengar improvingthequalityofbloodpressuremeasurementsinanoutpatientdiabetesclinic AT shafaqkhairi improvingthequalityofbloodpressuremeasurementsinanoutpatientdiabetesclinic AT jessicaefennelly improvingthequalityofbloodpressuremeasurementsinanoutpatientdiabetesclinic
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Improving the quality of blood pressure measurements in an outpatient diabetes clinic

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