Improving Hypertension Management Through the Implementation of a Self-Measured Blood Pressure Model

Abstract

Problem: Hypertension (HTN) is one of the leading risk factors for cardiovascular disease. Despite various approaches to control HTN including lifestyle modifications and medication management, more than half a million deaths in the United States are attributable to HTN, and only one in four adults have this condition under control. A primary care clinic identified the need to improve HTN management among its patients. While three out of five patients have a diagnosis of HTN, over 50% of the clinic’s population demonstrated evidence of worsening blood pressure (BP) trends despite usual care methods. Purpose: The purpose of this Quality Improvement (QI) initiative was to implement a self-measured blood pressure (SMBP) model to improve HTN management. The project is expected to benefit over one hundred adult patients per year treated at this clinic. Outcome goals include meeting a systolic BP target goal of £130/80. Methods: Baseline data was collected through a review of health records containing HTN as a managed condition within the clinic. Patients who demonstrated evidence of poor BP control were referred to the SMBP program. Elements of the SMBP included home BP monitoring, a written BP log, and telemedicine follow up. Clinic staff were trained to use corresponding tools by the American Heart Association (AHA) to guide the education provided. Weekly chart audits were completed to monitor the percentage of daily referrals completed, SBP trends, as well as medication changes throughout the implementation. Results: Results revealed increase and maintenance in identifying and referring eligible patients to the SMBP program, steady integration of SMBP by the patients enrolled, and 50% of participating patients achieved SBP target goal £130/80. Conclusions: Findings suggest the integration of a SMBP program positively impacted and improved clinical management of HTN during the implementation period. The benefits from this QI project included improved over-all clinic management of HTN and improved SBP.