Abstract:
OBJECTIVE: Elevated blood pressure (BP) and hypertension in childhood convey risk for hypertension and cardiovascular events in adulthood. Early recognition of abnormal BPs is key to preventing or lessening this risk. However, the process for making the diagnosis of hypertension is complex, and overall adherence to the 2017 American Academy of Pediatrics Clinical Practice Guidelines (CPG) is poor. We will review obstacles to adherence to the CPG and approaches designed to improve the diagnosis and management of hypertension in children.
RESULTS: Baseline data from the multi-center quality improvement intervention, \"Boosting Primary Care Awareness and Treatment of Hypertension\" (BP-CATCH), demonstrate that childhood hypertension remains underdiagnosed. Other studies confirm a lack of compliance with the process outlined in the CPG. The provision of electronic prompts, coaching, and education results in modest improvements. The combination of embedded medical record tools and education seems to offer the most hope for improvement.
摘要:
目的:儿童期血压(BP)升高和高血压会导致成年期高血压和心血管事件的风险。早期识别异常BP是预防或减少这种风险的关键。然而,诊断高血压的过程很复杂,对2017年美国儿科学会临床实践指南(CPG)的总体依从性较差.我们将回顾坚持CPG的障碍以及旨在改善儿童高血压诊断和管理的方法。
结果:来自多中心质量改进干预的基线数据,“提高初级保健意识和高血压治疗”(BP-CATCH),证明儿童高血压仍未被诊断。其他研究证实不符合CPG中概述的流程。提供电子提示,Coaching,教育带来了适度的改善。嵌入式医疗记录工具和教育的结合似乎为改进提供了最大的希望。