Factors associated with discussing high blood pressure readings in clinical notes.

Autor:	Chapman CG; University of Iowa, Department of Pharmacy Practice and Science., Polgreen PM; University of Iowa, Department of Internal Medicine., Suneja M; University of Iowa, Department of Internal Medicine., Carter BL; University of Iowa, Department of Pharmacy Practice and Science., Polgreen LA; University of Iowa, Department of Pharmacy Practice and Science.
Jazyk:	angličtina
Zdroj:	American journal of hypertension [Am J Hypertens] 2024 Dec 11. Date of Electronic Publication: 2024 Dec 11.
DOI:	10.1093/ajh/hpae153
Abstrakt:	Background: Blood pressure (BP) is routinely measured and recorded at healthcare visits, but high BP (HBP) measurements are not always discussed in clinical notes. Our objective was to identify patient- and visit-level factors associated with discussion of HBP measurements in clinical notes, among patients without prior diagnosis of hypertension. Methods: Data from 2016-2022 for all patients with any BP record of 140/90 mmHg or greater were obtained from University of Iowa Hospitals and Clinics electronic medical records. Patients with any prior hypertension diagnosis were excluded. We used a multi-level regression model to evaluate differences in the rates of discussing HBP. The model included varying intercepts for visit specialty and non-varying slopes and intercepts for patient- and visit-level features. Results: The final sample included 278,766 outpatient visits for 27,423 patients, of which 61,739 visits had HBP. Only 31% of visits with HBP had associated clinical notes with discussion of HBP. Even in primary-care-related clinics, HBP measurements were discussed in only 70% of visits. Factors associated with decreased odds of HBP being discussed in clinical notes included fever (OR: 0.46; 95%CI: 0.24-0.86) or external injury or pain (0.84; 0.79-0.90), and larger number of comorbidities (6+: 0.27; 0.22-0.32). Discussion of HBP in clinical notes was more likely among visits of patients with prior visits where HBP was discussed in clinical notes (12.36; 11.75-13.01). Conclusions: We found that discussion of HBP is relatively uncommon. Increasing discussion of hypertension in clinical notes could decrease hypertension-related diagnostic inertia. (© The Author(s) 2024. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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