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  • Measure Summary
  • NQMC:010057
  • Nov 2014

Hypertension diagnosis and treatment: percentage of adult patients age greater than or equal to 18 years diagnosed with chronic kidney disease whose blood pressure is at SBP less than 140 mmHg and DBP less than 90 mmHg.

Institute for Clinical Systems Improvement (ICSI). Quality improvement support: hypertension diagnosis and treatment. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014. 9 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in January 2016.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of adult patients age greater than or equal to 18 years diagnosed with chronic kidney disease whose blood pressure is at systolic blood pressure (SBP) less than 140 mmHg and diastolic blood pressure (DBP) less than 90 mmHg.

Rationale

The priority aim addressed by this measure is to increase the percentage of patients with chronic disease whose blood pressure (BP) is under control.

Eighth Joint National Committee (JNC 8) Recommendation (4) is fully endorsed by the Institute for Clinical Systems Improvement (ICSI) Hypertension Diagnosis and Treatment Work Group:

"In the population aged greater than or equal to 18 years with chronic kidney disease (CKD), initiate pharmacologic treatment to lower BP at systolic blood pressure (SBP) greater than or equal to 140 mmHg or diastolic blood pressure (DBP) greater than or equal to 90 mmHg and treat to goal SBP less than 140 mmHg and goal DBP less than 90 mmHg" (James et al., 2014).

Evidence for Rationale

Institute for Clinical Systems Improvement (ICSI). Hypertension diagnosis and treatment. Recommendation table. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014. 8 p.

Institute for Clinical Systems Improvement (ICSI). Quality improvement support: hypertension diagnosis and treatment. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014. 9 p.

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-20. [45 references] PubMed External Web Site Policy

Primary Health Components

Hypertension; chronic kidney disease (CKD); systolic blood pressure (SBP); diastolic blood pressure (DBP)

Denominator Description

Number of adult patients age greater than or equal to 18 years diagnosed with chronic kidney disease

Numerator Description

Number of adult patients diagnosed with chronic kidney disease whose blood pressure is at systolic blood pressure (SBP) less than 140/90 mmHg and diastolic blood pressure (DBP) less than 90 mmHg

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Ambulatory/Office-based Care

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Clinical Practice or Public Health Sites

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 18 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

The time frame pertaining to data collection is quarterly.

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of adult patients age greater than or equal to 18 years diagnosed with chronic kidney disease

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of adult patients diagnosed with chronic kidney disease whose blood pressure is at systolic blood pressure (SBP) less than 140/90 mmHg and diastolic blood pressure (DBP) less than 90 mmHg

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Type of Health State

Physiologic Health State (Intermediate Outcome)

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Percentage of adult patients age ≥ 18 years diagnosed with chronic kidney disease whose blood pressure is at SBP < 140 mmHg and DBP < 90 mmHg.

Measure Collection Name

Hypertension Diagnosis and Treatment

Submitter

Institute for Clinical Systems Improvement - Nonprofit Organization

Developer

Institute for Clinical Systems Improvement - Nonprofit Organization

Funding Source(s)

The Institute for Clinical Systems Improvement's (ICSI's) work is funded by the annual dues of the member medical groups and five sponsoring health plans in Minnesota and Wisconsin.

Composition of the Group that Developed the Measure

Work Group Members: Tony Woolley, MD (Work Group Leader); Ian Kenning, MD; Henry Maranga Kerandi, MD; David Luehr, MD; Karen Margolis, MD, MPH; Patrick J. O'Connor, MD, MA, MPH; Chrystian R. Pereira, PharmD; Allyson M. Schlichte, PharmD, MBA, BCACP

Financial Disclosures/Other Potential Conflicts of Interest

The Institute for Clinical Systems Improvement (ICSI) has long had a policy of transparency in declaring potential conflicting and competing interests of all individuals who participate in the development, revision and approval of ICSI guidelines and protocols.

In 2010, the ICSI Conflict of Interest Review Committee was established by the Board of Directors to review all disclosures and make recommendations to the board when steps should be taken to mitigate potential conflicts of interest, including recommendations regarding removal of work group members. This committee has adopted the Institute of Medicine Conflict of Interest standards as outlined in the report Clinical Practice Guidelines We Can Trust (2011).

Where there are work group members with identified potential conflicts, these are disclosed and discussed at the initial work group meeting. These members are expected to recuse themselves from related discussions or authorship of related recommendations, as directed by the Conflict of Interest committee or requested by the work group.

The complete ICSI policy regarding Conflicts of Interest is available at the ICSI Web site External Web Site Policy.

Disclosure of Potential Conflicts of Interest

Ian Kenning, MD (Work Group Member)
Physician, Primary Care, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: Consulting: None

Henry Maranga Kerandi, MD (Work Group Member)
Physician, Family Medicine, Hennepin Country Medical Center
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

David Luehr, MD (Work Group Member)
Medical Director, Family Medicine, Integrity Health Network
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Karen Margolis, MD, MPH (Work Group Member)
Director Clinical Research, HealthPartners Institute for Education and Research/Internal Medicine, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: WHI work groups and US Preventive Services Task Force systematic review group relevant to hypertension
Research Grants: Receives programmatic support for NIH funded trials and NIH consulting
Financial/Non-Financial Conflicts of Interest: None

Patrick J. O'Connor, MD, MA, MPH (Work Group Member)
Senior Clinical Investigator, HealthPartners Institute for Education and Research, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: ADA GL 2011-2012, ICSI guidelines: Diagnosis and Management of Type 2 Diabetes Mellitus in Adults, Lipid Management in Adults
Research Grants: Receives programmatic support for NIH funded trials and NIH consulting
Financial/Non-Financial Conflicts of Interest: Grants/Pending Grants; Patents, Royalties, or any Compensation for Intellectual Review, NIH

Chrystian R. Pereira, PharmD (Work Group Member)
Assistant Professor, Clinical Pharmacy, University of Minnesota Physicians
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Allyson M. Schlichte, PharmD, MBA, BCACP (Work Group Member)
Medication Therapy Management (MTM) Operations Lead and MTM Provider, Pharmacy, Fairview Health Services
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Tony Woolley, MD (Work Group Leader)
Physician, Internal Medicine, Park Nicollet Health Services
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2014 Nov

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in January 2016.

Source(s)

Institute for Clinical Systems Improvement (ICSI). Quality improvement support: hypertension diagnosis and treatment. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2014. 9 p.

Measure Availability

Source available from the Institute for Clinical Systems Improvement (ICSI) Web site External Web Site Policy.

For more information, contact ICSI at 8009 34th Avenue South, Suite 1200, Bloomington, MN 55425; Phone: 952-814-7060; Fax: 952-858-9675; Web site: www.icsi.org External Web Site Policy; E-mail: icsi.info@icsi.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on May 15, 2015.

The information was reaffirmed by the measure developer on January 13, 2016.

Copyright Statement

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.

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