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- Title
The accuracy of clinician perceptions of "usual" blood pressure control.
- Authors
Rose, Adam J; Shimada, Stephanie L; Rothendler, James A; Reisman, Joel I; Glassman, Peter A; Berlowitz, Dan R; Kressin, Nancy R
- Abstract
<bold>Background: </bold>The term "clinical inertia" is used to describe the failure to manage a chronic condition aggressively enough to bring it under control. The underlying mechanisms for clinical inertia remain poorly understood.<bold>Objective: </bold>To describe one potential mechanism for clinical inertia, seen through the lens of clinician responses to a computerized hypertension reminder.<bold>Design: </bold>Cohort study.<bold>Participants: </bold>A total of 509 hypertensive patients from 2 primary care clinics in urban Veterans Health Administration (VA) Medical Centers. All patients had elevated blood pressure (BP) values that triggered a computerized reminder. Given a set of possible responses to the reminder, clinicians asserted at least once for each patient that medication adjustments were unnecessary because the BP was "usually well controlled".<bold>Measurements: </bold>Using recent BP values from the electronic medical record, we assessed the accuracy of this assertion.<bold>Results: </bold>In most instances (57%), recent BP values were not well controlled, with the systolic BP (56%) much more likely to be elevated than the diastolic BP (13%). Eighteen percent of recent systolic BP values were 160 mmHg or greater.<bold>Conclusions: </bold>When clinicians asserted that the BP was "usually well controlled", objective evidence frequently suggested otherwise. This observation provides insight into one potential mechanism underlying clinical inertia.
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 2, p180
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-007-0464-1