August 21, 2013
California Health Network Program Doubles Hypertension Control Rates
redOrbit Staff & Wire Reports - Your Universe Online
One California health system’s efforts to help high blood pressure patients through a comprehensive treatment program resulted in a reduction in hypertension-related stroke and heart disease risk, claims research published Tuesday in the Journal of the American Medical Association (JAMA).Through the program, experts from Kaiser Permanente Northern California (a coalition of 21 hospitals and 73 doctors’ offices) managed to nearly double the rate of blood pressure control among adult patients diagnosed between 2001 and 2009. The rate of hypertension control throughout their network increased from 43.6 in 2001 to 80.4 percent eight years later, the authors of the JAMA study explained in a statement.
During that time, the national mean control rate increased from 55.4 percent to 64.1 percent, while the California state control rate increased from 63.4 percent in 2006 (the first year for which the data was available) to 69.4 percent in 2009. Those percentages are according to the Healthcare Effectiveness Data and Information Set quality measurement set by the National Committee for Quality Assurance, the researchers noted.
“I think there are many parts of this program that would likely be applicable in other primary care settings,” lead author Dr. Marc Jaffe, an endocrinologist at Kaiser Permanente South San Francisco Medical Center, told Reuters Health. “Since the end of the study, the hypertension control rates (at Kaiser) have continued to improve, and as of 2011, our control rates were as high as 87 percent.”
Elements of the Kaiser Permanente Northern California (KPNC) hypertension program include the creation of a comprehensive hypertension registry, the development and sharing of performance metrics, and the establishment of evidence-based guidelines. Furthermore, the approach calls for medical assistant visits for blood pressure measurement, and single-pill combination pharmacotherapy, in which multiple drugs are combined into one pill.
“Two features likely played a big role in the program's success,” said Lindsey Tanner of the Associated Press (AP). The first was the single-pill combination therapy, which combined the blood pressure drugs lisinopril and a diuretic into a less expensive, easier-to-take form of treatment.
The other part of the program Tanner credits for its success is the fact, starting in 2007, officials at KPNC “began offering free follow-up visits with medical assistants, rather than doctors, checking blood pressure readings. Besides charging no insurance copayment, these brief visits were available at more flexible times, increasing chances that patients would stick with the program.”
Dr. Jaffe called KPNC’s initiative the “first successful, large-scale program” of its kind to be sustained over a long period of time. He noted the study’s success, and the health system’s continued positive results in recent years, “has huge implications for the health of our members” because it reduces their risk of suffering from a stroke or heart disease. Hypertension affects a reported 65 million American adults (or nearly 30 percent of all US residents over the age of 18) and is a major contributor to cardiovascular disease.