title: Implementing effective hypertension quality improvement strategies: barriers and potential solutions.
abstract: Many quality improvement strategies have focused on improving blood pressure control, and these strategies can target the patient, the provider, and/or the system. Strategies that seem to have the biggest effect on blood pressure outcomes are team change, patient education, facilitated relay of clinical information, and promotion of self-management. Barriers to effective blood pressure control can affect the patient, the physician, the system, and/or "cues to action."We review the barriers to achieving blood pressure control and describe current and potential creative strategies for optimizing blood pressure control. These include home-based disease management, combined patient and provider education, and automatic decision support systems. Future research must address which components of quality improvement interventions are most successful in achieving blood pressure control.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA 94115, USA. judith.walsh@ucsf.edu
authors.forename: Judith M E
authors.initials: JM
authors.lastname: Walsh
authors.forename: Vandana
authors.initials: V
authors.lastname: Sundaram
authors.forename: Kathryn
authors.initials: K
authors.lastname: McDonald
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Owens
authors.forename: Mary Kane
authors.initials: MK
authors.lastname: Goldstein
mesh_terms: D002140:California; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000517:prevention & control; D008962:Models, Theoretical; D010818:Practice Patterns, Physicians' / Q000458:organization & administration / Q000592:standards / Q000639:trends; D011787:Quality of Health Care; D017749:Total Quality Management; D014481:United States