Recidivism to uncontrolled blood pressure in patients with previously controlled hypertension

Sandhu, Amneet; Ho, P. Michael; Asche, Steve; Magid, David J.; Margolis, Karen L.; Sperl-Hillen, JoAnn M.; Rush, Bill; Price, David; Ekström, Heidi; Tavel, Heather M.; Godlevsky, Olga V.; O’Connor, Patrick J.

doi:10.1016/j.ahj.2015.03.012

Cited by 13 publications

(10 citation statements)

References 26 publications

(17 reference statements)

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“…2,5,6 However, in these papers, there was no consideration of new patients entering the clinics or loss of patients from the clinic on an annual basis. Because controlling chronic disease and disease progression is challenging, [15][16][17][18] it is important to evaluate patients at increased risk more frequently than patients at lower risk. The stress on clinic capacity to serve these patients is therefore of importance.…”

Section: Discussionmentioning

confidence: 99%

Modelling the impact of new patient visits on risk adjusted access at 2 clinics

Kolber

Rueda

Sory

2018

Evaluation Clinical Practice

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Value-based care is driven by control of cost while maintaining quality of care. In order to control cost, there has been a drive to increase visit frequency in primary care for those patients at increased risk. Adding new patients to primary care clinics limits the availability of follow-up slots that accrue over time for those at highest risk, thereby limiting disease and, potentially, cost control. If frequency of established care visits can be reduced by improved disease control, closing the practice to new patients, hiring health care extenders, or providing non-face to face care models then quality and cost of care may be improved.

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Section: Discussionmentioning

confidence: 99%

Modelling the impact of new patient visits on risk adjusted access at 2 clinics

Kolber

Rueda

Sory

2018

Evaluation Clinical Practice

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“…20 Other studies conducted in other parts of the world by Li YT et al and Sandhu A et al showed significant association between poor adherence to antihypertensive medication and uncontrolled hypertension. 21,22 Other risk factors of uncontrolled hypertension Some of the potential risk factors such as gender, education, occupation, physical activity and intake of fruits and vegetables were not significant in the regression model. This was primarily due to the small sample size which was calculated only to determine the prevalence of uncontrolled hypertension.…”

Section: Predictive Factors Of Uncontrolled Hypertensionmentioning

confidence: 93%

Prevalence and risk factors of uncontrolled hypertension in the urban population of Kerala

Lalu

John

Paul

et al. 2021

Int J Community Med Public Health

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Background: Hypertension is leading risk factor for cardiovascular diseases and stroke, and leads to 12.8% of all deaths in the world. Uncontrolled hypertension doubles the risk of cardiovascular disease among the adults with hypertension. Globally 65% of the treated hypertensive have uncontrolled hypertension and in Kerala about three forth of the treated hypertensive have poor blood pressure control. The burden of uncontrolled hypertension is suggestive of preventable deaths and cardiovascular events.Methods: A cross-sectional study was conducted among 1210 residents of Kochi Corporation of Kerala aged 18 years and above during the period of Sept. 2014 to Sept. 2016. Pre-tested, semi-structured questionnaire was used to collect data on socio-demographic factors such as age, sex, occupation, socio-economic status, education and marital status. Behavioural factors such smoking, alcohol intake, physical activity and dietary factors were collected. Data was analysed by using statistical package for social sciences software version 20.0.Results: The prevalence of uncontrolled hypertension was 13.14% among the study population. Majority of the uncontrolled hypertensive were females (67.3%) and belonged to the age group 45 years and above (92.5%). The independent predictive factors of uncontrolled hypertension were additional salt intake (aOR 3.62; 95% CI 1.36-9.66), health education by a doctor (aOR 3.58; 95% CI 1.48-8.64), poor adherence to medication (aOR 4.45; 95% CI 1.23-16.03) and patients having no other co-morbidity (aOR 3.24; 95% CI 1.36-7.72).Conclusions: The burden of uncontrolled hypertension was high in this urban setting. A comprehensive measure involving doctors and healthcare workers have to be adopted to achieve optimum blood pressure among the hypertensive.

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“…Uncontrolled BP is defined as having SBP ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg at least once during the preceding 12 months [54]. We have chosen a broad definition of uncontrolled BP as over 25% of patients with previously controlled BP lack BP control over the following year, likely due to nonadherence [55,56].…”

Section: Methodsmentioning

confidence: 99%

Using Values Affirmation to Reduce the Effects of Stereotype Threat on Hypertension Disparities: Protocol for the Multicenter Randomized Hypertension and Values (HYVALUE) Trial

Daugherty¹,

Vupputuri²,

Hanratty³

et al. 2019

JMIR Res Protoc

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Background Medication nonadherence is a significant, modifiable contributor to uncontrolled hypertension. Stereotype threat may contribute to racial disparities in adherence by hindering a patient’s ability to actively engage during a clinical encounter, resulting in reduced activation to adhere to prescribed therapies. Objective The Hypertension and Values (HYVALUE) trial aims to examine whether a values-affirmation intervention improves medication adherence (primary outcome) by targeting racial stereotype threat. Methods The HYVALUE trial is a patient-level, blinded randomized controlled trial comparing a brief values-affirmation writing exercise with a control writing exercise among black and white patients with uncontrolled hypertension. We are recruiting patients from 3 large health systems in the United States. The primary outcome is patients’ adherence to antihypertensive medications, with secondary outcomes of systolic and diastolic blood pressure over time, time for which blood pressure is under control, and treatment intensification. We are comparing the effects of the intervention among blacks and whites, exploring possible moderators (ie, patients’ prior experiences of discrimination and clinician racial bias) and mediators (ie, patient activation) of intervention effects on outcomes. Results This study was funded by the National Heart, Lung, and Blood Institute. Enrollment and follow-up are ongoing and data analysis is expected to begin in late 2020. Planned enrollment is 1130 patients. On the basis of evidence supporting the effectiveness of values affirmation in educational settings and our pilot work demonstrating improved patient-clinician communication, we hypothesize that values affirmation disrupts the negative effects of stereotype threat on the clinical interaction and can reduce racial disparities in medication adherence and subsequent health outcomes. Conclusions The HYVALUE study moves beyond documentation of race-based health disparities toward testing an intervention. We focus on a medical condition—hypertension, which is arguably the greatest contributor to mortality disparities for black patients. If successful, this study will be the first to provide evidence for a low-resource intervention that has the potential to substantially reduce health care disparities across a wide range of health care conditions and populations. Trial Registration ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB). International Registered Report Identifier (IRRID) DERR1-10.2196/12498

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Recidivism to uncontrolled blood pressure in patients with previously controlled hypertension

Cited by 13 publications

References 26 publications

Modelling the impact of new patient visits on risk adjusted access at 2 clinics

Modelling the impact of new patient visits on risk adjusted access at 2 clinics

Prevalence and risk factors of uncontrolled hypertension in the urban population of Kerala

Using Values Affirmation to Reduce the Effects of Stereotype Threat on Hypertension Disparities: Protocol for the Multicenter Randomized Hypertension and Values (HYVALUE) Trial

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