Effectiveness of a Best Practice Alerts at Improving Hypertension Control

Area of Science:

• Health Informatics
• Clinical Quality Improvement
• Cardiovascular Medicine

Background:

• Suboptimal blood pressure (BP) control in hypertension (HTN) contributes to significant morbidity and mortality.
• Primary care visit complexity and missed opportunities hinder effective HTN management.
• Electronic health records (EHRs) with best practice alerts (BPAs) can identify patients with poor BP control.

Purpose of the Study:

• To evaluate the impact of EHR-based BPAs on patient follow-up and BP control.
• To identify patient subgroups with differential responses to BPA implementation.

Main Methods:

• Retrospective analysis of EHR data from adult primary care patients.
• Logistic regression to assess the association of BPA activation with BP follow-up and control.
• Control periods were established before, during, and after BPA implementation.

Main Results:

• BPA activation correlated with decreased patient follow-up rates.
• Certain demographics and health conditions (e.g., Black non-Hispanics, Hispanics, CKD, diabetes, obesity) were linked to increased follow-up.
• For patients who did follow-up, BPA activation was associated with improved BP control.

Conclusions:

• BPAs show potential for improving BP control in hypertension management.
• The observed reduction in patient follow-up necessitates careful consideration in BPA design and implementation.
• Future quality improvement initiatives should employ experimental designs for robust impact assessment.