Treatment Intensification Does Not Always Lead to Better Quality of Care in Patients with Hypertension
Authors: Barbara J. Turner, David St. Michel, Simon Tang
Journal: Annals of Internal Medicine (2008)

Letters2 September 2008Treatment Intensification Does Not Always Lead to Better Quality of Care in Patients with HypertensionBarbara J. Turner, MD, MSEd, David St. Michel, MPH, and Simon Tang, MPHBarbara J. Turner, MD, MSEdFrom the University of Pennsylvania, Philadelphia, PA 19107; Drexel University, Philadelphia, PA 19103; and Pfizer, New York, NY 10017., David St. Michel, MPHFrom the University of Pennsylvania, Philadelphia, PA 19107; Drexel University, Philadelphia, PA 19103; and Pfizer, New York, NY 10017., and Simon Tang, MPHFrom the University of Pennsylvania, Philadelphia, PA 19107; Drexel University, Philadelphia, PA 19103; and Pfizer, New York, NY 10017.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-5-200809020-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Valderas raises concerns about evaluating the quality of care for uncontrolled hypertension at only 1 visit, as we do in our article. We concur that a physician should not intensify treatment when a patient has been poorly adherent. Recommendations about lifestyle changes may also be reasonable depending on the patient's blood pressure. Because of these short-term factors, Kerr and colleagues (1) suggested that quality of care should be evaluated only after 2 consecutive visits with an elevated blood pressure. In light of this recommendation, we examined hypertension management in 2 urban primary care practices for patients age ...References1. Kerr EA, Krein SL, Vijan S, Hofer TP, Hayward RA. Avoiding pitfalls in chronic disease quality measurement: a case for the next generation of technical quality measures. Am J Manag Care. 2001;7:1033-43. [PMID: 11725807] MedlineGoogle Scholar2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72. [PMID: 12748199] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Barbara J. Turner, MD, MSEd; David St. Michel, MPH; Simon Tang, MPHAffiliations: From the University of Pennsylvania, Philadelphia, PA 19107; Drexel University, Philadelphia, PA 19103; and Pfizer, New York, NY 10017.Disclosures: Dr. Turner has received unrestricted research funding from Pfizer. Mr. Tang is employed by Pfizer. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Unrelated Comorbid Conditions on Hypertension Management Barbara J. Turner , Christopher S. Hollenbeak , Mark Weiner , Thomas Ten Have , and Simon S.K. Tang Treatment Intensification Does Not Always Lead to Better Quality of Care in Patients with Hypertension Jose M. Valderas Metrics Cited byIntensifying Therapy for Hypertension Despite Suboptimal Adherence 2 September 2008Volume 149, Issue 5Page: 362-363KeywordsBlood pressureForecastingHealth care qualityHypertensionPatientsResearch fundingRunningStable coronary artery diseaseStrokeSystolic pressure ePublished: 2 September 2008 Issue Published: 2 September 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...