Office-based interventions for recognizing abnormal pediatric blood pressures

Interventions to improve pediatric blood pressure (BP) screening have not been well studied. The authors measured staff acceptance of 2 simple in-office interventions and measured the effect on physician recognition of elevated BP measurements. Group 1 used simplified normative pediatric BP tables affixed to the growth chart, group 2 used a personal digital assistant program (PDA) to calculate BP percentiles as part of the vital signs, and group 3 served as the control. Group detection rates by compliant (C) and noncompliant (NC) with the intervention were: (1) (BP table) C = 18%, NC = 12%; (2) (PDA) C = 33%, NC = 26%; and (3) (control) 18%. There was no statistically significant intervention effect with documented compliance (P = .27) nor was there an effect in the noncompliant records (P = .12). Although the interventions were used inconsistently, their presence in the medical record did not improve performance. Future education and interventions are needed to reduce barriers to elevated pediatric BP recognition.