Will Running the Numbers First Violate the Principles of Patient-Centered Care?
Authors: Lawrence S. Phillips
Journal: Annals of Internal Medicine (2008)

Letters2 December 2008Will Running the Numbers First Violate the Principles of Patient-Centered Care?Lawrence S. Phillips, MD and Jennifer G. Twombly, MDLawrence S. Phillips, MDFrom the Veterans' Affairs Medical Center, Decatur, GA 30033, and Emory University School of Medicine, Atlanta, GA 30322.Search for more papers by this author and Jennifer G. Twombly, MDFrom the Veterans' Affairs Medical Center, Decatur, GA 30033, and Emory University School of Medicine, Atlanta, GA 30322.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-11-200812020-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank the responders to our editorial for their thoughtful concerns, but we believe that hypertension management needs improvement and we would like to address the issues raised in these letters.Although “clinical inertia” can be a pejorative term, acknowledging our own deficiencies (1) was a key first step in improving our care (2). Requiring that every detail of recommendations for care be based on evidence from clinical trials can lead to evidence-based paralysis (3)—failure to act in the absence of specific trial-based evidence. The goal of systolic blood pressure of less than 140 mm Hg is well ...References1. el-Kebbi IM, Ziemer DC, Musey VC, Gallina DL, Bernard AM, Phillips LS. Diabetes in urban African-Americans. IX. Provider adherence to management protocols. Diabetes Care. 1997;20:698-703. [PMID: 9135929] CrossrefMedlineGoogle Scholar2. Ziemer DC, Doyle JP, Barnes CS, Branch WT, Cook CB, El-Kebbi IM, et al. An intervention to overcome clinical inertia and improve diabetes mellitus control in a primary care setting: Improving Primary Care of African Americans with Diabetes (IPCAAD) 8. Arch Intern Med. 2006;166:507-13. [PMID: 16534036] CrossrefMedlineGoogle Scholar3. Ziemer DC, Phillips LS. The dogma of “tight control”: beyond the limits of evidence—author reply. Arch Intern Med. 2006;166:1672. CrossrefGoogle Scholar4. 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Blood pressure variability and organ damage in a general population: results from the PAMELA study (Pressioni Arteriose Monitorate E Loro Associazioni). Hypertension. 2002;39:710-4. [PMID: 11882636] CrossrefMedlineGoogle Scholar8. Kamoi K, Miyakoshi M, Soda S, Kaneko S, Nakagawa O. Usefulness of home blood pressure measurement in the morning in type 2 diabetic patients. Diabetes Care. 2002;25:2218-23. [PMID: 12453964] CrossrefMedlineGoogle Scholar9. Kerr EA, Zikmund-Fisher BJ, Klamerus ML, Subramanian U, Hogan MM, Hofer TP. The role of clinical uncertainty in treatment decisions for diabetic patients with uncontrolled blood pressure. Ann Intern Med. 2008;148:717-27. [PMID: 18490685] LinkGoogle Scholar10. Turner BJ, Hollenbeak CS, Weiner M, Ten Have T, Tang SS. Effect of unrelated comorbid conditions on hypertension management. Ann Intern Med. 2008;148:578-86. [PMID: 18413619] LinkGoogle Scholar11. Phillips LS, Branch WT, Cook CB, Doyle JP, El-Kebbi IM, Gallina DL, et al. Clinical inertia. Ann Intern Med. 2001;135:825-34. [PMID: 11694107] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Veterans' Affairs Medical Center, Decatur, GA 30033, and Emory University School of Medicine, Atlanta, GA 30322.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Inertia Lawrence S. Phillips , William T. Branch Jr. , Curtiss B. Cook , Joyce P. Doyle , Imad M. El-Kebbi , Daniel L. Gallina , Christopher D. Miller , David C. Ziemer , and Catherine S. Barnes Effect of Unrelated Comorbid Conditions on Hypertension Management Barbara J. Turner , Christopher S. Hollenbeak , Mark Weiner , Thomas Ten Have , and Simon S.K. Tang The Role of Clinical Uncertainty in Treatment Decisions for Diabetic Patients with Uncontrolled Blood Pressure Eve A. Kerr , Brian J. Zikmund-Fisher , Mandi L. Klamerus , Usha Subramanian , Mary M. Hogan , and Timothy P. Hofer It's Time to Overcome Clinical Inertia Lawrence S. Phillips and Jennifer G. Twombly Will Running the Numbers First Violate the Principles of Patient-Centered Care? Cynthia M. Boyd and Bruce Leff Will Running the Numbers First Violate the Principles of Patient-Centered Care? Sandeep Vijan , Rodney A. Hayward , and Peter Ubel Will Running the Numbers First Violate the Principles of Patient-Centered Care? Robert C. Sherrick Will Running the Numbers First Violate the Principles of Patient-Centered Care? Sam F. Carter Metrics Cited ByEthical issues in the neurology of aging and cognitive decline 2 December 2008Volume 149, Issue 11Page: 840-841KeywordsBlood pressureClinical trialsConflicts of interestElderlyHypertensionParalysisRunningSystolic pressureType 1 diabetes ePublished: 2 December 2008 Issue Published: 2 December 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...