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Assessment of factors influencing blood pressure control in a managed care population

Tanya M Romain1, Rosalie P Patel, Andrea M Heaberlin

  • 1Henry Ford Health System, Taylor, Michigan 48180, USA.

Pharmacotherapy
|August 19, 2003
PubMed

Insights

Most patients met blood pressure control goals (Health Plan Employer Data Information Set - HEDIS). Achieving HEDIS goals was linked to fewer medications and lower costs, though diabetes management remains challenging.

Area of Science:

  • Cardiology
  • Public Health
  • Health Services Research

Background:

  • Blood pressure control is crucial for managing chronic conditions like diabetes and after myocardial infarction.
  • Health Plan Employer Data Information Set (HEDIS) criteria provide benchmarks for quality healthcare.
  • Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) guidelines offer evidence-based recommendations.

Purpose of the Study:

  • Determine the percentage of patients meeting HEDIS blood pressure control criteria.
  • Identify factors associated with achieving or not achieving HEDIS blood pressure goals.
  • Assess compliance with JNC-VI recommendations for patients with diabetes and myocardial infarction.

Main Methods:

  • Retrospective analysis of 502 patient records from three primary care clinics.
  • Patients were commercial members of a health maintenance organization.
  • Data included medication use, drug costs, and adherence to clinical guidelines.

Main Results:

  • 74% of patients met HEDIS blood pressure control criteria (< or = 140/90 mm Hg).
  • Patients meeting HEDIS goals used fewer blood pressure drugs (p=0.023) and had lower drug costs (p=0.016).
  • Under JNC-VI, 46% of diabetic patients reached <130/85 mm Hg; 85% of post-MI patients received beta-blockers.

Conclusions:

  • Achieving target blood pressure exceeded national averages and correlated with reduced medication use and cost.
  • Effective blood pressure management in diabetic patients remains an area needing improvement.
  • Current practices show good adherence to some JNC-VI guidelines for specific conditions.

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