scholarly journals Electronic health records show high proportion of patients above audit standards for blood pressure control in England

2005 ◽  
Vol 18 (5) ◽  
pp. A116-A116
Author(s):  
F TAGGART ◽  
M THOROGOOD ◽  
D SINGER
Keyword(s):  
Blood Pressure ◽  
Electronic Health Records ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Health Records ◽  
Electronic Health ◽  
Audit Standards

scholarly journals Genome-wide association analyses using electronic health records identify new loci influencing blood pressure variation

2016 ◽  
Vol 49 (1) ◽  
pp. 54-64 ◽  
Author(s):  
Thomas J Hoffmann ◽  
Georg B Ehret ◽  
Priyanka Nandakumar ◽  
Dilrini Ranatunga ◽  
Catherine Schaefer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Health Records ◽  
Pressure Variation ◽  
Genome Wide Association ◽  
Health Records ◽  
Association Analyses ◽  
Genome Wide ◽  
Blood Pressure Variation ◽  
Electronic Health

scholarly journals The PCORnet Blood Pressure Control Laboratory

2020 ◽  
Vol 13 (3) ◽  
Author(s):  
Mark J. Pletcher ◽  
Valy Fontil ◽  
Thomas Carton ◽  
Kathryn M. Shaw ◽  
Myra Smith ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Health Record ◽  
Blood Pressure Control ◽  
Comparative Effectiveness ◽  
Pressure Control ◽  
Health Record ◽  
Control Laboratory ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health

Background: Uncontrolled blood pressure (BP) is a leading preventable cause of death that remains common in the US population despite the availability of effective medications. New technology and program innovation has high potential to improve BP but may be expensive and burdensome for patients, clinicians, health systems, and payers and may not produce desired results or reduce existing disparities in BP control. Methods and Results: The PCORnet Blood Pressure Control Laboratory is a platform designed to enable national surveillance and facilitate quality improvement and comparative effectiveness research. The platform uses PCORnet, the National Patient-Centered Clinical Research Network, for engagement of health systems and collection of electronic health record data, and the Eureka Research Platform for eConsent and collection of patient-reported outcomes and mHealth data from wearable devices and smartphones. Three demonstration projects are underway: BP track will conduct national surveillance of BP control and related clinical processes by measuring theory-derived pragmatic BP control metrics using electronic health record data, with a focus on tracking disparities over time; BP MAP will conduct a cluster-randomized trial comparing effectiveness of 2 versions of a BP control quality improvement program; BP Home will conduct an individual patient-level randomized trial comparing effectiveness of smartphone-linked versus standard home BP monitoring. Thus far, BP Track has collected electronic health record data from over 826 000 eligible patients with hypertension who completed ≈3.1 million ambulatory visits. Preliminary results demonstrate substantial room for improvement in BP control (<140/90 mm Hg), which was 58% overall, and in the clinical processes relevant for BP control. For example, only 12% of patients with hypertension with a high BP measurement during an ambulatory visit received an order for a new antihypertensive medication. Conclusions: The PCORnet Blood Pressure Control Laboratory is designed to be a reusable platform for efficient surveillance and comparative effectiveness research; results from demonstration projects are forthcoming.

scholarly journals Association between comorbidities and blood pressure trajectories in patients with hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Canoy ◽  
J Tran ◽  
R Norton ◽  
R Ayala Solares ◽  
N Conrad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Health Records ◽  
Funding Source ◽  
Lower Blood Pressure ◽  
Health Records ◽  
Lower Blood ◽  
Hypertension Diagnosis ◽  
Electronic Health ◽  
Multimorbid Patients ◽  
Over Time

Abstract Background Our knowledge of how to better manage elevated blood pressure in presence of comorbidities is limited; in part due to exclusion or underrepresentation of multimorbid patients from major clinical trials. Purpose To investigate the burden and types of comorbidities in patients with hypertension, to assess how such comorbidities and other variables affect blood pressure levels over time. Methods The study was conducted using linked electronic health records from the UK Clinical Practice Research Datalink study from its inception on 1 January 1985 to 30 September 2015. Using linked electronic health records, we compared systolic blood pressure levels among 295,487 patients with diagnosed hypertension by type and numbers of major comorbidities from at least 5 years before to up to 10 years after hypertension diagnosis. We used a multiple landmark cohort design in order to investigate associations prospectively with time-updated information that takes advantage of the dynamic nature of electronic health records. Results Time-updated multivariable linear regression analyses showed that the presence of more comorbidities was independently associated with lower blood pressure during follow-up. This negative association was not specific to particular types of comorbidities; although associations were stronger in those with pre-existing cardiovascular disease. Tracking patients backwards to years prior to hypertension diagnosis revealed that the association between comorbidities and blood pressure were even more pronounced in years before hypertension diagnosis. Despite substantial declines in blood pressure in the first year after diagnosis, subsequent changes were modest, with no evidence of a more rapid decline in those with more or specific types of comorbidities. Conclusions Blood pressure levels at which patients were diagnosed with hypertension varied substantially and were lower when patients had more comorbidities. This early selection bias was a key determinant of long-term differences in blood pressure by comorbidity status and provides an additional explanation for the lower blood pressure in multimorbid patients. Mean SBP (mmHg) over time Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Institute for Health Research Oxford Biomedical Research Centre, Rhodes Trust and Clarendon Fund

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