Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Hannan JA[original query] |
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Impact of COVID-19-related care disruptions on blood pressure management and control in community health centers.
Meador M , Coronado F , Roy D , Bay RC , Lewis JH , Chen J , Cheung R , Utman C , Hannan JA . BMC Public Health 2022 22 (1) 2295 BACKGROUND: Uncontrolled hypertension is a leading risk factor for cardiovascular disease. To ensure continuity of care, community health centers (CHCs) nationwide implemented virtual care (telehealth) during the pandemic. CHCs use the Centers for Medicare & Medicaid Services (CMS) 165v8 Controlling High Blood Pressure measure to report blood pressure (BP) control performance. CMS 165v8 specifications state that if no BP is documented during the measurement period, the patient's BP is assumed uncontrolled. METHODS: To examine trends in BP documentation and control rates in CHCs as telehealth use increased during the pandemic compared with pre-pandemic period, we assessed documentation of BP measurement and BP control rates from December 2019 - October 2021 among persons ages 18-85 with a diagnosis of hypertension who had an in-person or telehealth encounter in 11 CHCs. Rates were compared between CHCs that did and did not implement self-measured BP monitoring (SMBP). RESULTS: The percent of patients with hypertension with no documented BP measurement was 0.5% in December 2019 and increased to 15.2% (overall), 25.6% (non-SMBP CHCs), and 11.2% (SMBP CHCs) by October 2021. BP control using CMS 165v8 was 63.5% in December 2019 and decreased to 54.9% (overall), 49.1% (non-SMBP), and 57.2% (SMBP) by October 2021. When assessing BP control only in patients with documented BP measurements, CHCs largely maintained BP control rates (63.8% in December 2019; 64.8% (overall), 66.0% (non-SMBP), and 64.4% (SMBP) by October 2021). CONCLUSIONS: The transition away from in-person to telehealth visits during the pandemic likely increased the number of patients with hypertension lacking a documented BP measurement, subsequently negatively impacting BP control using CMS 165v8. There is an urgent need to enhance the flexibility of virtual care, improve EHR data capture capabilities for patient-generated data, and implement expanded policy and systems-level changes for SMBP, an evidence-based strategy that can build patient trust, increase healthcare engagement, and improve hypertension outcomes. |
Improving hypertension control and cardiovascular health: An urgent call to action for nursing
Hannan JA , Commodore-Mensah Y , Tokieda N , Smith AP , Gawlik KS , Murakami L , Cooper J , Koob S , Wright KD , Cassarino D , Arslanian-Engoren C , Melnyk BM . Worldviews Evid Based Nurs 2022 19 (1) 6-15 BACKGROUND: Hypertension is a leading cause of cardiovascular disease (CVD) and affects nearly one in two adults in the United States when defined as a blood pressure of at least 130/80 mm Hg or on antihypertensive medication (Virani et al., 2021, Circulation, 143, e254). Long-standing disparities in hypertension awareness, treatment, and control among racial and ethnic populations exist in the United States. High-quality evidence exists for how to prevent and control hypertension and for the role nurses can play in this effort. In response to the 2020 Surgeon General's Call to Action to Control Hypertension, nursing leaders from 11 national organizations identified the critical roles and actions of nursing in improving hypertension control and cardiovascular health, focusing on evidence-based nursing interventions and available resources. AIMS: To develop a unified "Call to Action for Nurses" to improve control of hypertension and cardiovascular health and provide information and resources to execute this call. METHODS: This paper outlines roles that registered nurses, advanced practice nurses, schools of nursing, professional nursing organizations, quality improvement nurses, and nursing researchers can play to control hypertension and prevent CVD in the United States. It describes evidence-based interventions to improve cardiovascular health and outlines actions to bring hypertension and CVD to the forefront as a national priority for nursing. LINKING EVIDENCE TO ACTION: Evidence-based interventions exist for nurses to lead efforts to prevent and control hypertension, thus preventing much CVD. Nurses can take actions in their communities, their healthcare setting, and their organization to translate these interventions into real-world practice settings. |
Patients with undiagnosed hypertension: hiding in plain sight
Wall HK , Hannan JA , Wright JS . JAMA 2014 312 (19) 1973-4 According to the 2011–2012 National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey of the noninstitutionalized US population that combines interviews and physical examinations, 1 of 3 US adults (estimated at approximately 71 million people) has high blood pressure and almost half of these individuals (48.2%) do not have their blood pressure under control.1 Closer examination of the population with uncontrolled blood pressure reveals that 36.2% (estimated at approximately 13 million people) are neither aware of their hypertension nor taking antihypertensive medications.1 | A common assumption might be that these individuals are among the uninsured population without regular access to the health care system and who, consequently, have not had an opportunity for detection and diagnosis of hypertension. However, data from analysis of 2009–2012 NHANES show that among the unaware, untreated, and uncontrolled hypertensive population, 81.8% have health insurance, 82.5% have a usual source of care, and 61.7% have received care 2 or more times in the past year (written communication from Cathleen Gillespie, MS, Centers for Disease Control and Prevention, October 30, 2014). These data suggest that potentially millions of people with uncontrolled high blood pressure are being seen by health care professionals each year but remain undiagnosed and “hiding in plain sight” within clinical settings. |
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