Lay-Flurrie, SL;
Sheppard, JP;
Stevens, RJ;
Mallen, C;
Heneghan, C;
Hobbs, FDR;
Williams, B;
... McManus, RJ; + view all
(2021)
Impact of changes to national guidelines on hypertension-related workload: an interrupted time series analysis in English primary care.
British Journal of General Practice
, 71
(705)
E296-E302.
10.3399/bjgp21X714281.
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Abstract
Background: In 2011, National Institute for Health and Care Excellence (NICE) guidelines recommended the routine use of out-of-office blood pressure (BP) monitoring for the diagnosis of hypertension. These changes were predicted to reduce unnecessary treatment costs and workload associated with misdiagnosis. / Aim: To assess the impact of guideline change on rates of hypertension-related consultation in general practice. / Design and setting: A retrospective open cohort study in adults registered with English general practices contributing to the Clinical Practice Research Datalink between 1 April 2006 and 31 March 2017. / Method: The primary outcome was the rate of face-to-face, telephone, and home visit consultations related to hypertension with a GP or nurse. Age- and sex-standardised rates were analysed using interrupted time-series analysis. / Results: In 3 937 191 adults (median follow-up 4.2 years) there were 12 253 836 hypertension-related consultations. The rate of hypertension-related consultation was 71.0 per 100 person–years (95% confidence interval [CI] = 67.8 to 74.2) in April 2006, which remained flat before 2011. The introduction of the NICE hypertension guideline in 2011 was associated with a change in yearly trend (change in trend −3.60 per 100 person–years, 95% CI = −5.12 to −2.09). The rate of consultation subsequently decreased to 59.2 per 100 person–years (95% CI = 56.5 to 61.8) in March 2017. These changes occurred around the time of diagnosis, and persisted when accounting for wider trends in all consultations. / Conclusion: Hypertension-related workload has declined in the last decade, in association with guideline changes. This is due to changes in workload at the time of diagnosis, rather than reductions in misdiagnosis.
| Type: | Article |
|---|---|
| Title: | Impact of changes to national guidelines on hypertension-related workload: an interrupted time series analysis in English primary care |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3399/bjgp21X714281 |
| Publisher version: | https://doi.org/10.3399/bjgp21X714281 |
| Language: | English |
| Additional information: | © The Authors http://creativecommons.org/licenses/by/4.0/ This article is Open Access: CC BY 4.0 licence http://creativecommons.org/licences/by/4.0/). |
| Keywords: | blood pressure; consultation; general practice; guideline; hypertension; workload |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10127692 |
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