• Institute for Clinical Systems Improvement (ICSI). Hypertension diagnosis and treatment. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Oct. 59 p. [125 references]

Does not apply to this measure

This measure is used to assess the percentage of adult patients with hypertension who had a blood pressure reading less than 140/90 mmHg at their last clinic visit.

The priority aim addressed by this measure is to increase the percentage of adult patients in blood pressure control.

Hypertension; blood pressure control (less than 140 mmHg systolic and less than 90 mmHg diastolic)

Number of patients age 18 years and older who have a diagnosis of hypertension (see the related "Denominator Inclusions/Exclusions" field in the Complete Summary)

Number of patients with a diagnosis of hypertension who had a blood pressure reading at their last visit less than 140 mmHg systolic and less than 90 mmHg diastolic (see the related "Numerator Inclusions/Exclusions" field in the Complete Summary)

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Internal quality improvement

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

Age greater than or equal to 18 years

Either male or female

Unspecified

Unspecified

Unspecified

Unspecified

Unspecified

Unspecified

Living with Illness

Effectiveness

Users of care only

Number of patients age 18 years and older who have a diagnosis of hypertension

Medical groups may generate a list of patients meeting the inclusion criteria. This list would be newly created not less than every 6 to 12 months to remain current. Data may be collected by medical record review. Identify the blood pressure at the most recent office visit.

After review in one month, all eligible patients would return to the pool of eligible patients from which the following month's sample of charts would be randomly drawn.

Randomly selected cases may be reviewed monthly.

Patients associated with provider

Inclusions
Number of patients age 18 years and older who have a diagnosis of hypertension*

*Adult patients 18 years and older who have had an office visit within the previous 12 months having the following International Classification of Diseases, Ninth Revision (ICD-9) codes 401.0, 401.1, and/or 401.9.

Exclusions
Unspecified

All cases in the denominator are equally eligible to appear in the numerator

Clinical Condition
Encounter

Time window is a fixed period of time

Inclusions
Number of patients with a diagnosis of hypertension who had a blood pressure reading at their last visit less than 140 mmHg systolic and less than 90 mmHg diastolic

• Calculate the average of two or more systolic blood pressure and diastolic blood pressure readings taken at the most recent office visit to determine level of control.
• Go to the previous office visit if the most recent office visit was for sigmoidoscopy, injuries, or a visit at which local anesthesia such as lidocaine was given for a procedure.
• The mean of two or more systolic and the mean of two or more diastolic readings taken at the selected visit would be calculated. The mean systolic blood pressure and mean diastolic blood pressure may then be used to determine whether the patient has a blood pressure less than 140/90 mmHg.

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Encounter or point in time

Administrative data
Medical record

Not Individual Case

Clinical Outcome

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percentage of adult patients who have blood pressure less than 140/90 mmHg at their clinic visit.

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: Gary Schwartz, MD (Work Group Leader) (Mayo Clinic) (Nephrology); Patrick O'Connor, MD, MPH (HealthPartners Medical Group) (Family Practice); Anthony Woolley, MD (Park Nicollet Health Services) (Internal Medicine/Nephrology); Vincent Canzanello, MD (Mayo Clinic) (Nephrology); Lee Mork, MS, RPh (Allina Medical Clinic) (Pharmacy); Penny Fredrickson (ICSI) (Facilitator); Myounghee Hanson (ICSI) (Facilitator)

Measure was not adapted from another source.

2003 Apr

2008 Oct

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Hypertension diagnosis and treatment. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Oct. 53 p.

• Institute for Clinical Systems Improvement (ICSI). Hypertension diagnosis and treatment. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Oct. 59 p. [125 references]

This NQMC summary was completed by ECRI on February 6, 2004. This summary was updated by ECRI Institute on July 27, 2004, on November 16, 2005, on January 23, 2007, and again on February 19, 2009.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.