Pediatric High Blood Pressure Recognition Associated With Electronic Decision Support: A Cohort Analysis
Justin P Zachariah1, Tavleen Singh2, Shannon Collinson2
1Division of Pediatric Cardiology (J.P.Z., M.H., S.K.S.-T.), Texas Children's Hospital, Baylor College of Medicine, Houston.
Hypertension (Dallas, Tex. : 1979)
|October 16, 2024
Summary
A new initiative improved recognition of high blood pressure (BP) in children and adolescents. This approach enhanced BP measurement and management, even in disadvantaged populations, showing promising results for pediatric cardiovascular health.
Area of Science:
- Pediatric Cardiology
- Public Health Initiatives
- Health Disparities
Background:
- Pediatric high blood pressure (BP) is a predictor of future cardiovascular disease.
- High BP in children is often underdiagnosed and undertreated, particularly in vulnerable populations.
- Effective management strategies are crucial for long-term pediatric health outcomes.
Purpose of the Study:
- To assess the impact of a comprehensive initiative on provider recognition of high blood pressure in a pediatric setting.
- To evaluate the effectiveness of the initiative across diverse patient demographics, including disadvantaged groups.
- To identify improvements in BP measurement, diagnosis, and management following the intervention.
Main Methods:
- A multi-component initiative involving provider retraining, equipment deployment, and an electronic decision support tool was implemented.
- Data on BP and patient characteristics were collected during 14-month pre- and post-intervention periods.
- Incident BP recognition was defined by diagnostic codes, problem list entries, referrals, testing, repeat visits, or antihypertensive prescriptions.
Main Results:
- The proportion of children and adolescents with measured high BP decreased significantly post-intervention (30% to 14% and 15%, respectively).
- Provider recognition of high BP increased by 58% in children and 43% in adolescents.
- Improvements in BP recognition were observed across disadvantaged racial, ethnic, and geographic groups, indicating reduced disparities.
Conclusions:
- A comprehensive initiative effectively improved high blood pressure measurement and provider recognition in pediatric patients.
- The initiative demonstrated success in reaching and benefiting disadvantaged populations, mitigating disparities in care.
- Further research is recommended to address sustained recognition and optimize electronic decision support for pediatric BP management.
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