Explicit and implicit evaluation of physician adherence to hypertension guidelines

Gail Ardery; Barry L Carter; Jessica L Milchak; George R Bergus; Jeffrey D Dawson; Paul A James; Carrie Franciscus; Yoonsang Kim

doi:10.1111/j.1524-6175.2007.06112.x

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Explicit and implicit evaluation of physician adherence to hypertension guidelines

Journal article

Open access

Peer reviewed

Explicit and implicit evaluation of physician adherence to hypertension guidelines

Gail Ardery, Barry L Carter, Jessica L Milchak, George R Bergus, Jeffrey D Dawson, Paul A James, Carrie Franciscus and Yoonsang Kim

The journal of clinical hypertension (Greenwich, Conn.), Vol.9(2), pp.113-119

02/2007

DOI: 10.1111/j.1524-6175.2007.06112.x

PMCID: PMC8110017

PMID: 17268216

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Abstract

This study evaluated physician adherence to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) hypertension guidelines in 6 community-based clinics. Explicit review of retrospective medical record data for patients with uncontrolled hypertension measured guideline adherence using 22 criteria. Mean overall guideline adherence was 53.5% and did not improve significantly over time. Random-effects models demonstrated significant associations between guideline adherence and various demographic and medical predictors, including age, minority status, comorbid conditions, and number of medications. A subsequent implicit review evaluated the degree to which nonadherence was justifiable and identified factors that might have affected adherence. Nonadherence was rated as justifiable for only 6.6% of the failed explicit criteria. In general, adherence to the JNC 7 guidelines was modest even when barriers that might have affected adherence were taken into consideration.

Guideline Adherence - standards

Humans

Middle Aged

Hypertension - drug therapy

Male

Hospitals, Community

Iowa

Physicians - standards

Aged, 80 and over

Adult

Female

Aged

Practice Guidelines as Topic

Details

Title: Subtitle: Explicit and implicit evaluation of physician adherence to hypertension guidelines
Creators: Gail Ardery - The University of Iowa College of Pharmacy, Iowa City, IA 52242-1112, USA
Barry L Carter
Jessica L Milchak
George R Bergus
Jeffrey D Dawson
Paul A James
Carrie Franciscus
Yoonsang Kim
Resource Type: Journal article
Publication Details: The journal of clinical hypertension (Greenwich, Conn.), Vol.9(2), pp.113-119
DOI: 10.1111/j.1524-6175.2007.06112.x
PMID: 17268216
PMCID: PMC8110017
NLM abbreviation: J Clin Hypertens (Greenwich)
ISSN: 1524-6175
eISSN: 1751-7176
Publisher: United States
Grant note: R01 HL070740 / NHLBI NIH HHS
Language: English
Date published: 02/2007
Academic Unit: Physician Assistant Studies; Public Health Administration; Psychiatry; Biostatistics; Family and Community Medicine; Pharmacy Practice and Science
Record Identifier: 9983997346302771

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