Document Detail

Quality indicators to measure blood pressure management over a time interval.
MedLine Citation:
PMID:  21396237     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Quality indicators are an important part of the primary care landscape, but focus strongly on point-in-time measurements, such as a patient's last blood pressure (BP) measurement. There is a larger space of possible measurements, including ones that more explicitly consider management over an interval of time.
OBJECTIVE: To determine the predictive abilities of five different quality indicators related to poor BP control.
METHODS: Data from two New Zealand general practices was analysed on five BP control indicators for patients with diagnosed hypertension: 1) last BP high (>150/90 mmHg); 2) last BP high or no BP measurement; 3) two or more consistently high BP measurements for ≥90 days; 4) a high BP then lapse of >120 days in BP measurement; and 5) antihypertensive medication possession ratio (MPR) of <80%. Probability that a patient would be identified by each indicator for the nine-month evaluation period ending 31 March 2009 was computed for each indicator one quarter, two quarters and three quarters prior to this date. Associations among the five indicators for the evaluation period were also calculated.
RESULTS: Positive predictive value (PPV) of indicators for the same indicator nine months later ranged from 27% (last BP high) to 64% (MPR). PPVs among the five measures with respect to the same time period ranged from 9% to 77% (median 33%).
CONCLUSIONS: Modest PPVs between indicators suggest the importance of considering multiple indicators to incentivise best management across diverse aspects of BP control.
Thusitha Mabotuwana; Jim Warren; C Raina Elley; John Kennelly; Chris Paton; Kuinileti Chang Wai; Stewart Wells
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Informatics in primary care     Volume:  18     ISSN:  1476-0320     ISO Abbreviation:  Inform Prim Care     Publication Date:  2010  
Date Detail:
Created Date:  2011-03-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101150138     Medline TA:  Inform Prim Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  149-56     Citation Subset:  IM    
School of Population Health, Department of General Practice and Primary Health Care, School of Population Health.
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