Outcomes/Effectiveness Research

South Carolina's initiative to reduce hypertension rates trains hypertension specialists and provides advice to doctors

Hypertension and its related problems continue to drain South Carolina of about $9 billion a year in direct medical costs and indirect costs such as lost productivity. To reduce this burden, the State began a Hypertension Initiative in April 1999 to provide feedback and cardiovascular risk management advice to primary care providers and train hypertension specialists. By monitoring prescribing patterns through a data feedback program, providing evidence-based management approaches through continuing medical education (CME) seminars, and applying improved treatment protocols, physicians can have a profound impact on hypertension, according to an update on the program, which was supported in part by the Agency for Healthcare Research and Quality (HS10871).

According to the update, the initiative has educated over 400 doctors throughout the State on management of hypertension, lipid disorders, and diabetes via a series of continuing medical education programs. The data monitoring and feedback component involving 20,000 hypertensive patients currently provides about 100 doctors with reports that indicate the percentage of patients who are meeting BP control targets, percentage of patients with high levels of blood lipids meeting LDL cholesterol goals, and percentage of diabetic patients achieving target blood-sugar levels. Finally, the State has certified 63 hypertension specialists in South Carolina. In the future, the investigators hope to add a dynamic health promotion program to active disease management efforts.

More details are in "2003 update on the hypertension initiative of South Carolina," by Melani Giese, R.N., B.S.N., Daniel Lackland, Dr.P.H., Jan Basile, M.D., and Brent Egan, M.D., in the June 2003 Journal of the South Carolina Medical Association 99(6), pp. 157-161.

Editor's Note: A related AHRQ-supported study (HS10856) reveals that hypertensive patients' awareness of blood pressure targets and current hypertension control status is suboptimal. For details, see "Patient knowledge and awareness of hypertension is suboptimal: Results from a large health maintenance organization," by Alexander, M., Gordon, N.P., Davis, C.C., and Chen, R.S., in the July 2003 Journal of Clinical Hypertension 5, pp. 254-260.

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