National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (1)
- (-) Blood Pressure (14)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Diabetes (1)
- (-) Diagnostic Safety and Quality (14)
- Electronic Health Records (EHRs) (2)
- Emergency Department (3)
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- Obesity (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedBryant KB, Green MB, Shimbo D
Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go.
This analysis examined how historical use of home blood pressure monitoring (HBPM) aligns with current out-of-office BP monitoring recommendations for hypertensive US adults without a previous hypertension diagnosis and how HBPM use varies by patient characteristics. A cohort of 7185 adults aged 20 years or older without a diagnosis of hypertension or antihypertensive medication use and a high office BP (≥130/80 mm Hg) who participated in the National Health and Nutrition Examination Survey (NHANES) 2009 to 2014 cycle were included. Participants who answered as having self-initiated or physician recommended HBPM were categorized as having used or having been told to use HBPM. The authors estimate that 31.4 million US adults did not have diagnosed hypertension, were not taking antihypertensive medications, and had an office BP ≥130/80 mm Hg. Out of that population, 95.3% would have met criteria to undergo out-of-office BP monitoring by the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Only 3.6% (1.1 million) were told to use HBPM, and 15.7% had used HPBM. There were no differences in use by race/ethnicity, sex, health insurance status, or source of routine healthcare. The authors suggest the use of a telemonitoring system to improve ease of HBPM.
AHRQ-funded; HS024262.
Citation: Bryant KB, Green MB, Shimbo D .
Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go.
Hypertension 2022 Feb;79(2):e15-e17. doi: 10.1161/hypertensionaha.121.18463..
Keywords: Blood Pressure, Diagnostic Safety and Quality, Home Healthcare, Guidelines, Evidence-Based Practice
Liyanage-Don N, Fung D, Phillips E
Implementing home blood pressure monitoring into clinical practice.
The purpose of this study was to review data that supports the use of home blood pressure monitoring (HBPM) and to provide practical guidance to clinicians who wish to incorporate HBPM into their practice. Home blood pressure monitoring more accurately reflects the risk of cardiovascular events than office blood pressure measurements, and evidence supports the hypothesis that HBPM combined with clinical support improves blood pressure control. In spite of this, HBPM use remains low due to barriers between patients, clinicians, and healthcare system levels; understanding these barriers is crucial for the development of strategies to implement HBPM. This article considers how recommended best practices can facilitate the successful and effective implementation of HBPM.
AHRQ-funded; HS024262.
Citation: Liyanage-Don N, Fung D, Phillips E .
Implementing home blood pressure monitoring into clinical practice.
Curr Hypertens Rep 2019 Feb 12;21(2):14. doi: 10.1007/s11906-019-0916-0..
Keywords: Blood Pressure, Diagnostic Safety and Quality, Primary Care, Screening
Goldberg EM, Wilson T, Jambhekar B
Emergency department-provided home blood pressure devices can help detect undiagnosed hypertension.
This study researched the value of giving home blood pressure devices to patients in emergency departments (EDs) with a triage blood pressure (BP) of >= 120/80 mmHg and no history of hypertension. About 68% of the participants used the device at least 4 times. Those participants with elevated BP had follow-up with their primary care doctor 46% of the time.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Jambhekar B .
Emergency department-provided home blood pressure devices can help detect undiagnosed hypertension.
High Blood Press Cardiovasc Prev 2019 Feb;26(1):45-53. doi: 10.1007/s40292-019-00300-0..
Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality
Anstey DE, Muntner P, Bello NA
Diagnosing masked hypertension using ambulatory blood pressure monitoring, home blood pressure monitoring, or both?
The aim of this study was to determine the overlap between ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) for the detection of masked hypertension (MHT). The investigators asserted that their data suggested that conducting ABPM will detect many individuals with MHT who have an increased cardiovascular disease risk.
AHRQ-funded; HS024262.
Citation: Anstey DE, Muntner P, Bello NA .
Diagnosing masked hypertension using ambulatory blood pressure monitoring, home blood pressure monitoring, or both?
Hypertension 2018 Nov;72(5):1200-07. doi: 10.1161/hypertensionaha.118.11319..
Keywords: Blood Pressure, Diagnostic Safety and Quality
Rao G, Naureckas S, Datta A
Pediatric hypertension: diagnostic patterns derived from electronic health records.
This study examined the rates of diagnostic for pediatric hypertension using electronic health records (EHRs). The rates of diagnosis were very low (6.1%) among 1478 children identified as hypertensive. Rates of diagnosis improved in children aged 12 and above but was very low for children aged 6 and under. Underdiagnosis can lead to organ failure and increased risk for adult hypertension.
AHRQ-funded; HS024100.
Citation: Rao G, Naureckas S, Datta A .
Pediatric hypertension: diagnostic patterns derived from electronic health records.
Diagnosis 2018 Sep;5(3):157-60. doi: 10.1515/dx-2018-0010..
Keywords: Children/Adolescents, Blood Pressure, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Carter EJ, Moise N, Alcantara C
Patient barriers and facilitators to ambulatory and home blood pressure monitoring: a qualitative study.
Guidelines recommend that patients with newly elevated office blood pressure undergo ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to rule-out white coat hypertension before being diagnosed with hypertension. This study explored patients' perspectives of the barriers and facilitators to undergoing ABPM or HBPM.
AHRQ-funded; HS024262.
Citation: Carter EJ, Moise N, Alcantara C .
Patient barriers and facilitators to ambulatory and home blood pressure monitoring: a qualitative study.
Am J Hypertens 2018 Jul 16;31(8):919-27. doi: 10.1093/ajh/hpy062..
Keywords: Blood Pressure, Diagnostic Safety and Quality
Muldoon MF, Kronish IM, Shimbo D
Of signal and noise: overcoming challenges in blood pressure measurement to optimize hypertension care.
This paper reviews the manifestations and consequences of BP mismeasurement and misinterpretation in clinical practice and draw on recent research to propose a set of solutions that leverage available technologies to optimize hypertension care.
AHRQ-funded; HS024262.
Citation: Muldoon MF, Kronish IM, Shimbo D .
Of signal and noise: overcoming challenges in blood pressure measurement to optimize hypertension care.
Circ Cardiovasc Qual Outcomes 2018 May;11(5):e004543. doi: 10.1161/circoutcomes.117.004543..
Keywords: Blood Pressure, Diagnostic Safety and Quality, Adverse Events, Medical Errors, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Care
Kronish IM, Kent S, Moise N
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
The goal of the study was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. The study found that top-ranked barriers to home BP monitoring were concerns about compliance with the correct test protocol, accuracy of tests results, out-of-pocket costs of home BP devices, and time needed to instruct patients on home BP monitoring protocol.
AHRQ-funded; HS024262.
Citation: Kronish IM, Kent S, Moise N .
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
J Am Soc Hypertens 2017 Sep;11(9):573-80. doi: 10.1016/j.jash.2017.06.012..
Keywords: Blood Pressure, Primary Care, Diagnostic Safety and Quality, Screening
Bello JK, Mohanty N, Bauer V
Pediatric hypertension: provider perspectives.
The researchers aimed to gain insights into reasons for low rates of diagnosis and treatment from primary care providers. In interviews, providers reflected on numerous barriers to diagnosis, management, and follow-up; recommendations for educational content; and how community health center systems can be improved. Findings informed development of a multifaceted intervention.
AHRQ-funded; HS024100.
Citation: Bello JK, Mohanty N, Bauer V .
Pediatric hypertension: provider perspectives.
Glob Pediatr Health 2017 Jun 6;4:2333794x17712637. doi: 10.1177/2333794x17712637.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Healthcare Delivery, Blood Pressure, Obesity, Primary Care
Goldberg EM, Wilson T, Saucier C
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
The aims of this study were to (1) assess the reliability of ED triage blood pressure (BP) as a metric to establish when the CMS threshold (>/=120/80 mm Hg), and other clinically relevant BP thresholds (>/=140/90 and >/=160/100 mm Hg) have been met; and (2) determine whether correct identification varies by gender, race, or triage acuity. At the three suggested BP thresholds, 66.1 percent, 74.0 percent, and 88.8 percent of patients were confirmed to meet the CMS threshold, respectively. There were no differences by gender, race, or triage acuity.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Saucier C .
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
J Am Soc Hypertens 2017 May;11(5):290-94. doi: 10.1016/j.jash.2017.03.003.
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Keywords: Blood Pressure, Emergency Department, Quality Measures, Screening, Diagnostic Safety and Quality, Quality of Care
Brody AM, Sharma VK, Singh A
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
This study surveyed a national sample of emergency physicians on their perceived barriers in establishing an ED diagnosis of asymptomatic hypertension (HTN) and ED treatment of such patients. It found that the most common barriers to diagnosis of HTN were uncertainty regarding the validity of ED blood pressure measurements (92 percent)and reluctance to diagnose a condition which cannot be comprehensively managed in the ED setting (29 percent).
AHRQ-funded; HS000011.
Citation: Brody AM, Sharma VK, Singh A .
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
Am J Emerg Med 2016 Nov;34(11):2241-42. doi: 10.1016/j.ajem.2016.08.050.
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Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality, Chronic Conditions
Goldberg EM, Levy PD
New approaches to evaluating and monitoring blood pressure.
The authors reviewed the current literature on mobile health technologies and novel diagnostic and management protocols and made recommendations on how to incorporate these innovations into practice. They recommend collaboration between device designers and clinical researchers to develop rigorous clinical trials to test cardiovascular outcomes associated with emerging technologies.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Levy PD .
New approaches to evaluating and monitoring blood pressure.
Curr Hypertens Rep 2016 Jun;18(6):49. doi: 10.1007/s11906-016-0650-9.
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Keywords: Blood Pressure, Telehealth, Health Information Technology (HIT), Diagnostic Safety and Quality
Wallace ML, Magnan EM, Thorpe CT
Diagnosis and treatment of incident hypertension among patients with diabetes: a U.S. multi-disciplinary group practice observational study.
The researchers aimed to evaluate rates and associations of hypertension diagnosis and treatment among patients with diabetes mellitus and incident hypertension. They found that among patients with diabetes mellitus, even using a cut-point of 140/90 mmHg, approximately 50 percent remained undiagnosed and untreated for hypertension.
AHRQ-funded; HS018368.
Citation: Wallace ML, Magnan EM, Thorpe CT .
Diagnosis and treatment of incident hypertension among patients with diabetes: a U.S. multi-disciplinary group practice observational study.
J Gen Intern Med 2015 Jun;30(6):768-76. doi: 10.1007/s11606-015-3202-0..
Keywords: Blood Pressure, Diabetes, Diagnostic Safety and Quality, Chronic Conditions
Piper MA, Evans CV, Burda BU
Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force.
The purpose of this paper is to update a systematic review on the benefits and harms of screening for high BP in adults and to summarize evidence on rescreening intervals and diagnostic and predictive accuracy of different BP methods for cardiovascular events. It concluded that evidence supports ambulatory blood pressure monitoring as the reference standard for confirming elevated office BP screening results to avoid misdiagnosis and overtreatment of persons with isolated clinic hypertension.
AHRQ-funded; 290201200151I.
Citation: Piper MA, Evans CV, Burda BU .
Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Feb 3;162(3):192-204. doi: 10.7326/m14-1539..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Diagnostic Safety and Quality, Screening, Evidence-Based Practice, Guidelines