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Hypertension care during the COVID-19 pandemic in an integrated health care system

John F Steiner1,2, J David Powers1, Allen Malone1

  • 1Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA.

Journal of Clinical Hypertension (Greenwich, Conn.)
|March 15, 2023
PubMed

Insights

The COVID-19 pandemic disrupted hypertension care, leading to decreased medication adherence and a significant drop in blood pressure (BP) monitoring for many patients. However, most individuals who remained in care maintained their pre-pandemic BP control.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
  • Maintaining continuity of care for chronic conditions like hypertension is crucial for patient outcomes.
  • Disruptions in healthcare access and patient behaviors may have impacted hypertension management.

Purpose of the Study:

  • To evaluate the impact of the COVID-19 pandemic on hypertension care.
  • To assess changes in retention in care, medication adherence, and blood pressure control among hypertensive patients.
  • To compare hypertension care metrics during the pre-COVID-19 period and the first year of the pandemic.

Main Methods:

  • Retrospective cohort study of 64,766 individuals with treated hypertension.
  • Comparison of hypertension care from March 2019-February 2020 (pre-COVID-19) versus March 2020-February 2021 (COVID-19).
  • Key metrics included retention in care (BP measurements), medication adherence (prescription refills), in-person/virtual visits, and blood pressure changes.

Main Results:

  • 27.4% of patients lacked blood pressure measurements during the COVID-19 period.
  • Medication adherence decreased from 86.0% to 80.8% (p < .001).
  • In-person visits declined, while virtual contacts increased; however, blood pressure control remained stable for those in care.

Conclusions:

  • The COVID-19 pandemic led to a notable decline in hypertension care continuity and medication adherence.
  • Despite challenges, most patients who remained engaged in care maintained their blood pressure control.
  • Targeted outreach strategies are essential to ensure population-level hypertension control and restore care continuity.

Keywords:
COVID-19health maintenance organizationshypertensionmedication adherencepharmaceutical servicesretention in caretelemedicine

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