Proportion of ECR of patients over age 18 without code for Hypertension and without any measure of Blood Pressure

Sonia Zenari, Giulio Rigon, Francesco Del Zotti

Keywords: Audit; ECR; screening

Background:

Authoritative guidelines (1; 2) recommend blood pressure (BP) measurement in all patients aged 18 years and older

Research questions:

The main objective: what is the proportion of absence of measures of BP , enumerating for each GP the number of patients aged 18 years and over who are both without ICD9 code for diagnosis of arterial hypertension and without evaluation of at least one blood pressure measure in the Electronic Clinical Record (ECR)

Method:

A) For the extraction of data from their Database of ECR , GPs have used SQL phrases; B) the SQL phrase has extracted from its entire Database either patients from age 18 years or over with Hypertension code 401.9xx, either patients WITHOUT Hypertension code and WITHOUT PRESSURE measurement. In the data collection form, the participating GPs entered: 1. The total number of patients assisted; 2: The Total Number of Patients WITH ICD9 code for Hypertension; 3: the TOTAL of Patients WITHOUT Code for Hypertension and WITHOUT BP measurement in the ECR

Results:

Number of GPs participants ( of voluteer quality italian group "Netaudit") and their assisted population: 16 GPs, with a sum of assisted patients of 22402; an average patient for GPs of 1400 patients; median of 1496; minimum of 520 patients; maximum of 1578 patients.
Hypertensive Number: for all 16 GPS the total sum of hypertensive patients was 5569 patients: a proportion of the total number of patients (22402) equal to 24.8% (Confidence Interval from 24.2% to 25.4%).

Conclusions:

The total number of patients, aged 18 years or older, WITHOUT ICD9 code for Hypertension and WITHOUT BP measurement in the ECR is 5984: a proportion of the total number of assisted persons (22402) equal to 26.7% (with confidence interval from 26% to 27.3%). A connected variability was found between 16 GPs: the coefficient of variation is 78%

Points for discussion:

a) how can GPs increase this relative high proportion of Not recording of BP ?

b) how to ask the softwarehose of ECR of giving automatic sign to Gps with these "holes" for important measure as BP?

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