Hypertension is the most common reason for health office visits in the US and for the use of prescription drugs. Many patients fail to truly understand the diagnosis of high blood pressure and the various health consequences that comes with poor regulation such as cardiovascular disease, stroke and renal disease. This project was aimed to increase patient education on the implications of hypertension and its complications.https://scholarworks.uvm.edu/fmclerk/1200/thumbnail.jp

Huynh, Tinh Thanh

English

UVM ScholarWorks

University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects Larner College of Medicine2016Williston, VT: Increasing the Awareness ofHypertension Implications and SequelaeTinh Thanh HuynhUniversity of Vermont College of MedicineFollow this and additional works at: https://scholarworks.uvm.edu/fmclerkPart of the Medical Education Commons, and the Primary Care CommonsThis Book is brought to you for free and open access by the Larner College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion inFamily Medicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationHuynh, Tinh Thanh, "Williston, VT: Increasing the Awareness of Hypertension Implications and Sequelae" (2016). Family MedicineClerkship Student Projects. 245.https://scholarworks.uvm.edu/fmclerk/245Williston, VT: Increasing the Awareness of  Hypertension Implications and SequelaeThomas Chittenden Health CenterTinh HuynhRotation Two: 5/2016-6/2016Mentor: Dr. Dan Donnelly BP ClassificationProblem Identification• Hypertension is the most common reason for office visits in United States and for the use of  prescription drugs.• Complications include left ventricular hypertrophy, heart failure, ischemic stroke, ischemic heart disease, intracerebral hemorrhage and renal disease • ~29-31% of  adults in the US have hypertension (1 in 3 American adults)• ~8% of  adults in the US have undiagnosed hypertension• ~2% in ages of  adolescents have hypertensionPublic Health Costs• In 2011, total costs assoc. with hypertension in the US were ~$46 billion in health care services, medications and missed days of  work• In 2010-2030, annual costs directly attributable to hypertension are projected to increase ~$130.4 billion• In 2010-2030, total direct medical costs of  cardiovascular disease (hypertension being the most expensive component) are projected to triple from $272.5 billion to $818.1 billion• Primary prevention of  hypertension provides an opportunity to break the costly cycle of  managing its complicationsCommunity Perspective• Maryanne Kyburz Ladue, MNT• Maryanne is a Registered Dietitian/Nutrition Professional and Certified Diabetes Educator at the Thomas Chittenden Health Center• She estimated that ~70% of  her patients have HTN and ~20% of  her hypertensive patients have uncontrolled HTN due to non-compliance• She believes the best way to improve blood pressure regulation is patient education and is hopeful that this project can attribute to better health outcomes• Dr. Charles Maclean, MD• Dr. Maclean is the Associate Dean for Primary Care in the Department of  Medicine at UVM and is currently involved with a hypertension project funded by the health department• Due to lack of  patient education, he estimated that ~50% of  his hypertensive patients truly  understand the diagnosis and its complications• Dr. Maclean advocates that this project can help to not only increase hypertension awareness but also patient complianceIntervention• Literature review on the implications of  hypertension with incorporation of  pertinent facts into a concise, informative handout• Implementation of  an educational handout will provide an overview of  hypertension as well as treatment options, prevention methods and resources to help maintain health and wellness.• Goal of  intervention is to improve patient compliance and health outcomes by increasing awareness of  the implications of  high blood pressure and its complicationsResults• The response from the physicians, nurse practitioners and physician assistants at the Thomas Chittenden Health Center were very positive.• Healthcare providers believe that the handouts are concise and convenientenough for patients to easily comprehend the information in a timely manner. • Informational handouts were placed in waiting areas for patients to read prior to appointments or to bring home after appointments • Electronic copy was also made available for the office for emailing purposes and could potentially be attached to electronic follow-up appointment remindersEffectiveness and Limitations• Handouts are available in areas most convenient and obvious• By minimalizing medical jargon and condensing pertinent facts, handouts are effectively more patient-friendly• Patient interest, curiosity and literacy are limiting factors• Method efficacy could potentially be reflected by an increase in the number of  patients with blood pressure improvements over time through EMR (electronic medical records) reporting which unfortunately cannot be measured due to project time restraintsFuture Recommendations• Track the number of  hypertensive patients with blood pressure improvements• Generate EMR reports on the number of  hypertensive patients with blood pressure improvements prior to implementation and after implementation• Encourage physicians to be more vigilant about hypertension and use project handouts when applicableReferences• Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of  hypertension, 1988-2008. JAMA 2010; 303:2043.• Hsu CY, McCulloch CE, Darbinian J, et al. Elevated blood pressure and risk of  end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005; 165:923.• Kit BK, Kuklina E, Carroll MD, et al. Prevalence of  and trends in dyslipidemia and blood pressure among US children and adolescents, 1999-2012. JAMA Pediatr 2015; 169:272.• Levy D, Larson MG, Vasan RS, et al. The progression from hypertension to congestive heart failure. JAMA 1996; 275:1557.• Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation 2000; 102:470.• Mozzafarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2015 Update: a report from the American Heart Association. Circulation. 2015;e29-322.• Thrift AG, McNeil JJ, Forbes A, Donnan GA. Risk factors for cerebral hemorrhage in the era of  well-controlled hypertension. Melbourne Risk Factor Study (MERFS) Group. Stroke 1996; 27:2020.• Trogdon JG, Finkelstein EA, Nwaise IA, Tangka FK, Orenstein D. The economic burden of  chronic cardiovascular disease for major insurers. Health Promot Pract. 2007;8:234–242• Wilson PW. Established risk factors and coronary artery disease: the Framingham Study. Am J Hypertens 1994; 7:7S.• Wright JD, Hughes JP, Ostchega Y, et al. Mean systolic and diastolic blood pressure in adults aged 18 and over in the United States, 2001-2008. Natl Health Stat Report 2011; :1.Interview Consent Form• Thank you for agreeing to be interviewed. This project is a requirement for the Family Medicine clerkship. It will be stored on the Dana Library ScholarWorks website. Your name will be attached to your interview and you may be cited directly or indirectly in subsequent unpublished or published work. The interviewer affirms that he/she has explained the nature and purpose of  this project. 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Williston, VT: Increasing the Awareness of Hypertension Implications and Sequelae

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Williston, VT: Increasing the Awareness of Hypertension Implications and Sequelae

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