Abstract 15517: Physician-Patient Engagement to Improve Ambulatory Systolic Blood Pressure

Abstract

Listen

Translate article

Introduction: Hypertension is a leading cause of death and disability-adjusted life-years globally. Using implementation science of the 2017 ACC/AHA Guideline for High Blood Pressure (BP) in Adults, we posited a quality improvement (QI) project targeting physician education and multidisciplinary patient engagement in two large urban ambulatory clinics to improve patient blood pressures. Hypothesis: We hypothesize that direct physician and patient education and engagement improves achievement of hypertension goals within ambulatory clinics. Methods: A QI initiative consisting of a half-day of resident hypertension education, patient access to home BP monitors, and direct patient engagement via physician outreach was conducted. Patients not at BP goal defined as systolic blood pressure (SBP) >130 mmHg were followed over 8 months via multidisciplinary approach to ensure adequate follow-up appointments. Data was collected after 8-months and compared descriptively. BP ranges at month 0: Group A <130 mmHg, Group B 130-139 mmHg, Group C 140-159 mmHg, Group D >=160 mmHg. Emphasis was placed on Groups C and D. Results: A total of 6,030 patients had follow-up visits in the 8-month study window. At month 0, 874 patients fell within Group C and 301 within Group D. Of those in Group C, 29.5% achieved SBP goal (<130 mmHg), 27.5% improved BP to 130-139 mmHg, and 34.4% remained within 140-159 mmHg at month 8. In Group D, 20.9% achieved goal SBP <130 mmHg, 17.6% reached 130-139 mmHg, and 34.6% improved to 140-159 mmHg. (Figure 1). Limitations included patients without access to BP cuff during telehealth visits. Conclusions: Direct physician engagement and multidisciplinary approach to hypertension management led to decreased SBP readings. Further investigation is warranted to determine how these interventions affect long-term cardiovascular outcomes.