PMID- 20528221
OWN - NLM
STAT- MEDLINE
DCOM- 20100917
LR  - 20191210
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 26
IP  - 8
DP  - 2010 Aug
TI  - Assessment of time to follow-up visits in newly-treated hypertensive patients 
      using an electronic medical record database.
PG  - 1881-91
LID - 10.1185/03007995.2010.489785 [doi]
AB  - OBJECTIVE: Use of electronic medical record (EMR) data for evaluating healthcare 
      processes and outcomes is relatively new. Using EMR data, this study evaluated 
      the time from antihypertensive initiation to the first follow-up office visit 
      controlling for adverse events (AEs) and other factors that could influence 
      follow-up timing. Findings were compared to treatment guidelines which recommend 
      monthly follow-up in treatment naive patients until blood pressure (BP) levels 
      are controlled. RESEARCH DESIGN AND METHODS: Treatment-naive hypertensive adult 
      patients in the General Electric Centricity EMR database (1996-2006) with a new 
      antihypertensive prescription were evaluated. Time from treatment initiation to 
      first office visit was identified and stratified by occurrence of AEs and therapy 
      change. BP was assessed at 120 +/- 30 days. RESULTS: The mean +/- SD time from 
      first antihypertensive prescription (index date) to the first office visit was 
      96.2 +/- 160.6 days; 38% returned within a month of treatment initiation. 
      Controlling for baseline demographic and clinical characteristics, the adjusted 
      time until first office visit was shorter for those with an AE and therapy change 
      than for those with neither event (61 vs. 158 days). Of the patients with 
      follow-up BP data for analysis (n = 27,875), more of those seen within a month of 
      treatment initiation achieved BP goal at 120 days (<140/90 mmHg) than those who 
      were not seen within a month (64.3 vs. 61.7% respectively; p < 0.001). 
      CONCLUSIONS: This study demonstrates that EMR data can be used to assess quality 
      measures which in turn can inform efforts to improve treatment outcomes. 
      Specifically, this study evaluated mean time to first office visit after 
      antihypertensive therapy initiation controlling for clinical factors that could 
      influence office visit intervals based on data available in a national EMR 
      dataset. A key limitation of this study is that the EMR may not represent patient 
      care delivered by other providers, thus, use of antihypertensives, changes in 
      therapy, and office visits may be underreported.
FAU - Brixner, Diana I
AU  - Brixner DI
AD  - University of Utah College of Pharmacy, Department of Pharmacotherapy, Salt Lake 
      City, UT 84112, USA. Diana.Brixner@utah.edu
FAU - McAdam-Marx, Carrie
AU  - McAdam-Marx C
FAU - Ye, Xiangyang
AU  - Ye X
FAU - Lau, Helen
AU  - Lau H
FAU - Munger, Mark A
AU  - Munger MA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
SB  - IM
MH  - Aged
MH  - *Appointments and Schedules
MH  - Blood Pressure
MH  - Cohort Studies
MH  - Databases, Factual/statistics & numerical data
MH  - Electronic Health Records/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Guideline Adherence/*standards
MH  - Humans
MH  - Hypertension/*therapy
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods
MH  - Physicians' Offices/statistics & numerical data
MH  - Quality Assurance, Health Care/*methods
MH  - Retrospective Studies
EDAT- 2010/06/10 06:00
MHDA- 2010/09/21 06:00
CRDT- 2010/06/10 06:00
PHST- 2010/06/10 06:00 [entrez]
PHST- 2010/06/10 06:00 [pubmed]
PHST- 2010/09/21 06:00 [medline]
AID - 10.1185/03007995.2010.489785 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2010 Aug;26(8):1881-91. doi: 10.1185/03007995.2010.489785.