Health system: Greater ease, affordability ups blood pressure control

Giving patients easier-to-take medications, and making follow-up shorter, more convenient and more affordable can help lower blood pressure rates, concludes a study published Tuesday in the Journal of the American Medical Association.

A large-scale hypertension program at Kaiser Permanente Northern California (KPNC) did just that and nearly doubled hypertension control from 43.6 percent in 2001 to 80.4 percent in 2009, compared with modest improvements in state and national control rates.

KPNC, a nonprofit, integrated healthcare delivery system with 21 hospitals and 45 medical facilities, found success using a health system-wide hypertension registry that contained information on demographic characteristics of patients and giving clinicians a four-step evidence-based hypertension control algorithm for initial therapy and treatment intensification, according to the study.

"What's unique about this is the sheer scale of what they've done," Goutham Rao, a family medicine specialist at NorthShore University HealthSystem in Chicago, told the Associated Press. "If we were able to keep everyone's blood pressure under control in the United States, the number of new strokes and heart attacks would go down just exponentially," he said.

In 2005, KPNC's program incorporated the use of single-pill combination therapy into its guidelines, as single-pill combinations are associated with improved adherence and lower patient cost. And in 2007, the program offered three medical assistant follow-up visits for blood pressure measurement that reduced patient barriers by improving access to the medical team, eliminating co-payments, increasing scheduling flexibility and cutting visit times.

The study also cited quarterly and monthly performance feedback that identified and shared successful practices or innovations program-wide.

Meanwhile, another JAMA study last month revealed that home telemonitoring, combined with pharmacist case management, can help improve high blood pressure management for patients with the chronic condition. After the postintervention follow-up, roughly 72 percent of patients in the telemonitoring intervention group were able to control their blood pressure, compared with 57 percent of patients who did the same via usual care, FierceHealthIT previously reported.

For more:
- here's the JAMA study
- read the AP article

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