Process of care indicators among patients treated for hypertension at a tertiary care hospital in Puducherry, South India

Abstract

Background: Routine follow-ups, laboratory tests, and fundus examination are necessary in controlling blood pressure (BP) and thus control the complications of hypertension (HTN). Hence, in this study, we aimed to determine the process of care indicators among patients with HTN who have obtained care at a tertiary care center, South India. Methods: A hospital-based cross-sectional descriptive study was conducted among patients with HTN who were registered on or before September 2017 and were on treatment for a minimum of 1 year. Patient case records were retrospectively reviewed to identify the process indicators. Results: A total of 385 patients with HTN were included in this study. The mean (standard deviation) age was 57.9 (9.8) years and more than half were females (51.7%). Of total, 274 (71.2% [95% confidence interval (CI) 66.5–75.5]) patients have consulted their physicians on the last two scheduled visits and 62% (95% CI 56.9–66.5) have got their BPs measured. Only one-fifth underwent retinal examination and lipid profiling. Only 77 (20% [95% CI 15.8–23.7]) of the patients achieve at least three processes of care indicators we studied. Outcome indicators showed that around one-third (36.9%) of the participants had unsatisfactory outcome indicators with respect to BP control. Care-availing outpatients have 1.2 (95% CI 1–1.4) times higher poor care indicators (not underwent last three processes of care indicators) as compared to those availing care from HTN clinic (P = 0.01). Conclusions: We found suboptimal adherence to process of care indicators among patients with HTN availing care at a tertiary care hospital.

Keywords

• hypertension
• patient outcome assessment
• structured operational research and training initiative