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The following is a summary of “Development of quality indicators for hypertension, extractable from the electronic health record of the general practitioner: a rand-modified Delphi method,” published in the August 2024 issue of Primary Care by Danhieux et al.
Hypertension, a prevalent chronic medical condition affecting millions globally, stands as a significant contributor to cardiovascular diseases, necessitating a multidisciplinary approach to mitigate its impact. General practitioners (GPs) play a pivotal role in managing hypertension, making it essential that the care they provide is both high-quality and aligned with the latest European guidelines. Quality indicators (QIs) are instrumental in assessing healthcare delivery’s performance, outcomes, and processes, enabling healthcare professionals to pinpoint areas for improvement and track progress toward optimal health outcomes.
Despite their importance, QIs designed to evaluate hypertension care in general practice have yet to be sufficiently explored. This study aims to establish a set of quality indicators for hypertension management in general practice, which can be extracted from electronic health records (EHR) and utilized to enhance the quality of care for patients with hypertension.
The study employed a Rand-modified Delphi procedure, where recommendations were initially drawn from European guidelines and compiled into an online questionnaire. These recommendations were then evaluated by a panel of experts using the SMART (Specific, Measurable, Achievable, Relevant, Time-bound) principle, with a focus on their extractability from the EHR. The results were analyzed using a Median Likert score, prioritization, and degree of consensus. A consensus meeting followed, during which all recommendations were thoroughly discussed and subjected to a final validation round.
From an initial pool of 115 recommendations, the study identified 37 that met the criteria for inclusion after the online questionnaire and consensus meeting. Of these, 9 recommendations were slightly modified, and 4 were combined into 2, culminating in 35 recommendations. These recommendations were then translated into QIs, comprising 7 QIs for screening, 6 for diagnosis, 11 for treatment, 5 for outcomes, and 6 for follow-up.
In conclusion, this study produced a comprehensive set of 35 QIs specifically tailored for hypertension management in general practice, designed for integration with the Belgian EHR system. These QIs provide a robust framework for automated audit and feedback, offering significant potential to enhance the quality of hypertension care. Furthermore, this framework could be adapted to benefit other countries, facilitating the improvement of hypertension management on a broader scale.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02543-w
