scholarly journals Facility-level variation in diabetes and blood pressure control in patients with diabetes: Findings from the Veterans Affairs national database

2017 ◽  
Vol 40 (11) ◽  
pp. 1055-1060 ◽  
Author(s):  
Hasan Rehman ◽  
Julia M. Akeroyd ◽  
David Ramsey ◽  
Sarah T. Ahmed ◽  
Anwar T. Merchant ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Veterans Affairs ◽  
National Database ◽  
Level Variation ◽  
Patients With Diabetes ◽  
Facility Level

scholarly journals Facility-Level Variation in Cardiac Stress Test Use Among Patients With Diabetes: Findings From the Veterans Affairs National Database

Diabetes Care ◽  
2020 ◽  
Vol 43 (5) ◽  
pp. e58-e60
Author(s):  
Dhruv Mahtta ◽  
Sarah T. Ahmed ◽  
Nishant R. Shah ◽  
David J. Ramsey ◽  
Julia M. Akeroyd ◽  
...  
Keyword(s):  
Stress Test ◽  
Veterans Affairs ◽  
National Database ◽  
Level Variation ◽  
Cardiac Stress ◽  
Patients With Diabetes ◽  
Facility Level ◽  
Test Use ◽  
Cardiac Stress Test

scholarly journals Statin Use and Its Facility-Level Variation in Patients With Diabetes: Insight From the Veterans Affairs National Database

2016 ◽  
Vol 39 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Yashashwi Pokharel ◽  
Julia M. Akeroyd ◽  
David J. Ramsey ◽  
Ravi S. Hira ◽  
Vijay Nambi ◽  
...  
Keyword(s):  
Veterans Affairs ◽  
National Database ◽  
Level Variation ◽  
Patients With Diabetes ◽  
Facility Level ◽  
Statin Use

scholarly journals Impact of the COVID-19 Pandemic on Glycemic Control and Blood Pressure Control in Patients with Diabetes in Japan

2022 ◽  
Vol 61 (1) ◽  
pp. 37-48
Author(s):  
Keisuke Endo ◽  
Takayuki Miki ◽  
Takahito Itoh ◽  
Hirofumi Kubo ◽  
Ryosuke Ito ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Patients With Diabetes

Abstract P183: Minimal Impact of JAMA 2014 Guidelines on Blood Pressure Control in a Large Health System

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Alex R Chang ◽  
J E Hartle ◽  
Lawrence Appel ◽  
Morgan Grams
Keyword(s):  
Blood Pressure ◽  
Health System ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Mixed Effects Models ◽  
System Level ◽  
Minimal Impact ◽  
Before And After ◽  
Patients With Diabetes ◽  
Using Data

Background: JAMA 2014 blood pressure (BP) guidelines raised BP goals for adults older than 60 years (from <140/90 to <150/90) and adults with chronic kidney disease (CKD) or diabetes (from < 130/80 to <140/90). It is unknown whether there were changes in BP control at the health system level after guideline publication. Methods: Using data from 288,962 adults receiving primary care in the Geisinger Health System, we compared blood pressure control over 1-year time periods before and after the February 2014 publication of the JAMA 2014 BP guidelines (i.e. Aug 2012-July 2013 vs Aug 2014-July 2015). Mixed effects models were used, allowing intercepts to vary by individual, adjusted for age, gender, and race. Results: Mean age was 49.2 ± 18.3 y, 56.7% were female, and 2.5% were black. Prevalence of diagnoses for hypertension, diabetes, and CKD were 40.0%, 15.1%, and 11.4%, respectively. Overall, distributions of systolic BP were similar before and after JAMA 2014 BP guidelines (Figure). BP control <140/90 was also similar between the two periods for adults 18-59 y (90.9% vs. 90.3%; OR 1.01, 95% CI: 0.99-1.02; p=0.3), adults ≥ 60 y (81.8% vs 82.2%; OR 1.01, 95% CI: 1.00-1.03; p=0.05), and adults with diabetes (83.2% vs. 82.7%; OR 1.00, 95% CI: 0.99-1.02; p=0.7) whereas BP control <140/90 improved slightly for adults with CKD (81.7% vs. 82.1%; OR 1.06, 95% CI: 1.04-1.08; p<0.001). BP control <130/80 was marginally worse after JAMA 2014 BP guidelines in patients with diabetes (53.5% vs. 51.8%; OR 0.98, 95% CI: 0.96-0.99; p=0.01). Trends were similar in analyses only including patients with hypertension diagnoses (overall 78.6% vs. 78.2%, OR 1.00, 95% CI: 0.99-1.02; p=0.5), and when using a goal of < 130/80 for patients with CKD (53.3% vs. 53.5%; OR 1.06, 95% CI: 1.04-1.08; p<0.001). Conclusion: There was little change in blood pressure control in a large integrated health system after publication of the JAMA 2014 BP guidelines. These findings are reassuring given recent findings from the SPRINT trial supporting lower BP goals.

Cardiovascular disease-related chronic conditions among Veterans Affairs colorectal cancer survivors: A matched case-control analysis.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 4-4
Author(s):  
Leah L. Zullig ◽  
Valerie Smith ◽  
Jennifer Lindquist ◽  
Christina D. Williams ◽  
Morris Weinberger ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Blood Pressure ◽  
Cancer Survivors ◽  
Blood Pressure Control ◽  
Chronic Conditions ◽  
Cancer Control ◽  
Pressure Control ◽  
Veterans Affairs ◽  
Multiple Chronic Conditions ◽  
And Control

4 Background: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing CRC survivors and matched non-cancer controls, our objectives were to determine the odds of CRC survivors being diagnosed with CVD-related chronic conditions and their likelihood of control during the year after CRC diagnosis. Methods: We retrospectively identified patients diagnosed with non-metastatic CRC in the Veterans Affairs (VA) healthcare system from fiscal years 2009-2012 and matched each with up to 3 non-cancer control patients. We used logistic regression to assess differences in the likelihood of being diagnosed with CVD-related chronic conditions and control between CRC survivors and non-cancer controls. Results: We identified 9,758 CRC patients and matched them to 29,066 non-cancer controls. At baseline, 69.4% of CRC survivors and their matched controls were diagnosed with hypertension, 52.4% with hyperlipidemia, and 36.7% with diabetes. Compared to matched non-cancer controls, CRC survivors had 57% higher odds of being diagnosed with hypertension (OR = 1.57, 95% CI = 1.49-1.64) and 12% higher odds of poor blood pressure control (OR = 1.12, 95% CI 1.06-1.18) in the subsequent year. Compared to matched non-cancer control patients, CRC survivors had half the odds of being diagnosed with hyperlipidemia (OR = 0.50, 95% CI = 0.48-0.52) and higher odds of LDL control (OR 1.14, 95% CI 1.06-1.23). There were no significant differences between groups for diabetes diagnoses or control. Conclusions: Compared to non-cancer controls, CRC survivors have: 1) greater likelihood of being diagnosed with hypertension and worse blood pressure control in the year following diagnosis; 2) lower likelihood of being diagnosed with hyperlipidemia or LDL control; and 3) comparable diabetes diagnoses and control. There may be a need for hypertension control interventions targeting cancer survivors.

scholarly journals Improving Blood Pressure Control Through a Clinical Pharmacist Outreach Program in Patients With Diabetes Mellitus in 2 High-Performing Health Systems

Circulation ◽  
2012 ◽  
Vol 125 (23) ◽  
pp. 2863-2872 ◽  
Author(s):  
Michele Heisler ◽  
Timothy P. Hofer ◽  
Julie A. Schmittdiel ◽  
Joe V. Selby ◽  
Mandi L. Klamerus ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Health Systems ◽  
Blood Pressure Control ◽  
Clinical Pharmacist ◽  
Pressure Control ◽  
Outreach Program ◽  
High Performing ◽  
Patients With Diabetes
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