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Table 5 Process and outcome measures used in Project ReD CHiP

From: A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol

Type Measure+ Notes and definitions
Primary process measure % with uncontrolled BP with medication titration in last 3 months Uncontrolled BP ≥140/≥90 (or ≥130/≥80 if DM or chronic kidney disease); titration can be dose increase or medication change/addition
Secondary process measures % with BP measure in EMR in last 12 months  
% with history of pre-HTN with BP measure in last 12 months Two clinic BPs ≥120-<140≥80-<90; not on HTN medication
% with HTN with measure in last 6 months Two clinic BP ≥140/≥90 OR use of a HTN medication OR ICD9 diagnosis (401.xx)
% with HTN on a thiazide diuretic  
% with HTN and DM on ACE-I or ARB DM defined by ICD9 code 250.xx
% with lipid panel performed in last 5 years* May not be possible as EMR only in all clinics since March 2006
% with BP≥135/≥85 screened for DM in last 5 years* May not be possible as EMR only in all clinics since March 2006
Implementation uptake process measures % with BP measured with OMRON  
% of SBP and DBP measures ending in zero  
% of eligible patients enrolled in care management  
% completion rate for those enrolled in care management  
Provider behavioral intention related to assessment and partnership skills Measured at completion of the website review and at 6 months post-intervention
Change in provider self-reported use of assessment and partnership behaviors Measured before the website review and at 6 months post-intervention
% of providers receiving web training at each site Measured at 6 months post-intervention
Provider self-reported use of HTN dashboard Measured at 6 months post-intervention
Primary outcome measure % with controlled BP Controlled BP defined as <140/<90 (or <130/<80 if DM or chronic kidney disease present)
Secondary outcome measures % with controlled LDL Controlled LDL defined as <130 (or <100 if DM or coronary artery disease)
% with controlled HDL Controlled HDL defined as >50 in women or >40 in men
% with controlled triglycerides Controlled triglycerides defined as <150
% with controlled A1C Controlled A1C defined as <7.0
  Mean SBP, DBP, LDL, HDL, triglycerides, A1C  
  1. +Data are aggregated in one week intervals at baseline, during and after intervention roll-out for a minimum of 24 weeks.
  2. *These measures will only be performed in clinics that have had the EMR system in place for at least 5 years.
  3. Abbreviations: % percent, BP blood pressure, DM diabetes mellitus, EMR electronic medical record; HTN hypertension, ACE-I angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, SBP systolic blood pressure, DBP diastolic blood pressure, LDL low density lipoprotein, HDL high density lipoprotein, A1C glycated hemoglobin.