TY - JOUR
T1 - Factors Associated With Blood Pressure Control Among Patients in Community Health Centers
AU - Huguet, Nathalie
AU - Green, Beverly B.
AU - Voss, Robert W.
AU - Larson, Annie E.
AU - Angier, Heather
AU - Miguel, Marino
AU - Liu, Shuling
AU - Latkovic-Taber, Michaella
AU - DeVoe, Jennifer E.
N1 - Funding Information:
The authors acknowledge the participation of the partnering community health centers. The views presented in this article are solely the responsibility of the authors and do not necessarily represent the views of the funding agencies. OCHIN data are aggregated in the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Research Network. ADVANCE is led by OCHIN in partnership with Health Choice Network, Fenway Health, and the Robert Graham Center. ADVANCE is funded through the Patient-Centered Outcomes Research Institute (Contract Number RI-OCHIN-01-MC). This publication was supported by the National Health, Lung, and Blood Institute Grant Number R01HL136575. No financial disclosures were reported by the authors of this paper. Nathalie Huguet: Conceptualization, Methodology, Project administration, Writing - original draft, Writing - review & editing, supervision. Beverly B. Green: Conceptualization, Methodology, Writing - original draft, Writing - review & editing. Robert W. Voss: Software, Formal analysis, Data curation, Writing - review & editing. Annie E. Larson: Conceptualization, Methodology, Writing - review & editing. Heather Angier: Conceptualization, Methodology, Writing - review & editing. Miguel Marino: Conceptualization, Methodology, Writing - review & editing. Shuling Liu: Conceptualization, Methodology, Writing - review & editing. Michaella Latkovic-Taber: Software, Formal analysis, Data curation, Writing - review & editing. Jennifer E. DeVoe: Conceptualization, Methodology, Writing - review & editing, Funding acquisition.
Funding Information:
OCHIN data are aggregated in the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Research Network. ADVANCE is led by OCHIN in partnership with Health Choice Network, Fenway Health, and the Robert Graham Center. ADVANCE is funded through the Patient-Centered Outcomes Research Institute (Contract Number RI-OCHIN-01-MC). This publication was supported by the National Health, Lung, and Blood Institute Grant Number R01HL136575.
Publisher Copyright:
© 2022 American Journal of Preventive Medicine
PY - 2023/5
Y1 - 2023/5
N2 - Introduction: Understanding the multilevel factors associated with controlled blood pressure is important to determine modifiable factors for future interventions, especially among populations living in poverty. This study identified clinically important factors associated with blood pressure control among patients receiving care in community health centers. Methods: This study includes 31,089 patients with diagnosed hypertension by 2015 receiving care from 103 community health centers; aged 19–64 years; and with ≥1 yearly visit with ≥1 recorded blood pressure in 2015, 2016, and 2017. Blood pressure control was operationalized as an average of all blood pressure measurements during all the 3 years and categorized as controlled (blood pressure <140/90), partially controlled (mixture of controlled and uncontrolled blood pressure), or never controlled. Multinomial mixed-effects logistic regression models, conducted in 2022, were used to calculate unadjusted ORs and AORs of being in the never- or partially controlled blood pressure groups versus in the always-controlled group. Results: A total of 50.5% had always controlled, 39.7% had partially controlled, and 9.9% never had controlled blood pressure during the study period. The odds of being partially or never in blood pressure control were higher for patients without continuous insurance (AOR=1.09; 95% CI=1.03, 1.16; AOR=1.18; 95% CI=1.07, 1.30, respectively), with low provider continuity (AOR=1.24; 95% CI=1.15, 1.34; AOR=1.28; 95% CI=1.13, 1.45, respectively), with a recent diagnosis of hypertension (AOR=1.34; 95% CI=1.20, 1.49; AOR=1.19; 95% CI=1.00, 1.42), with inconsistent antihypertensive medications (AOR=1.19; 95% CI=1.11, 1.27; AOR=1.26; 95% CI=1.13, 1.41, respectively), and with fewer blood pressure checks (AOR=2.14; 95% CI=1.97, 2.33; AOR=2.17; 95% CI=1.90, 2.48, respectively) than for their counterparts. Conclusions: Efforts targeting continuous and consistent access to care, antihypertensive medications, and regular blood pressure monitoring may improve blood pressure control among populations living in poverty.
AB - Introduction: Understanding the multilevel factors associated with controlled blood pressure is important to determine modifiable factors for future interventions, especially among populations living in poverty. This study identified clinically important factors associated with blood pressure control among patients receiving care in community health centers. Methods: This study includes 31,089 patients with diagnosed hypertension by 2015 receiving care from 103 community health centers; aged 19–64 years; and with ≥1 yearly visit with ≥1 recorded blood pressure in 2015, 2016, and 2017. Blood pressure control was operationalized as an average of all blood pressure measurements during all the 3 years and categorized as controlled (blood pressure <140/90), partially controlled (mixture of controlled and uncontrolled blood pressure), or never controlled. Multinomial mixed-effects logistic regression models, conducted in 2022, were used to calculate unadjusted ORs and AORs of being in the never- or partially controlled blood pressure groups versus in the always-controlled group. Results: A total of 50.5% had always controlled, 39.7% had partially controlled, and 9.9% never had controlled blood pressure during the study period. The odds of being partially or never in blood pressure control were higher for patients without continuous insurance (AOR=1.09; 95% CI=1.03, 1.16; AOR=1.18; 95% CI=1.07, 1.30, respectively), with low provider continuity (AOR=1.24; 95% CI=1.15, 1.34; AOR=1.28; 95% CI=1.13, 1.45, respectively), with a recent diagnosis of hypertension (AOR=1.34; 95% CI=1.20, 1.49; AOR=1.19; 95% CI=1.00, 1.42), with inconsistent antihypertensive medications (AOR=1.19; 95% CI=1.11, 1.27; AOR=1.26; 95% CI=1.13, 1.41, respectively), and with fewer blood pressure checks (AOR=2.14; 95% CI=1.97, 2.33; AOR=2.17; 95% CI=1.90, 2.48, respectively) than for their counterparts. Conclusions: Efforts targeting continuous and consistent access to care, antihypertensive medications, and regular blood pressure monitoring may improve blood pressure control among populations living in poverty.
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U2 - 10.1016/j.amepre.2022.11.002
DO - 10.1016/j.amepre.2022.11.002
M3 - Article
C2 - 36609093
AN - SCOPUS:85148759042
SN - 0749-3797
VL - 64
SP - 631
EP - 641
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 5
ER -