Milan Wiedemann, Victoria Speed, Christine Cunningham, Rose Higgins, Helen J Curtis, Colm Andrews, Louis Fisher, Lisa Hopcroft, Christopher T Rentsch, Viyaasan Mahalingasivam, Laurie Tomlinson, Caroline Morton, Miriam Samuel, Amelia Green, Christopher Wood, Andrew D Brown, Jon Massey, Caroline Walters, Rebecca M Smith, Peter Inglesby, David Evans, Steven Maude, Iain Dillingham, Alex J Walker, Jessica Morley, Amir Mehrkar, Seb Bacon, Chris Bates, Jonathan Cockburn, John Parry, Frank Hester, Richard J McManus, Ben Goldacre, Brian MacKenna
{"title":"COVID-19 对英格兰记录在案的血压筛查和高血压管理的影响：OpenSAFELY 中质量和结果框架指标的月度变化分析。","authors":"Milan Wiedemann, Victoria Speed, Christine Cunningham, Rose Higgins, Helen J Curtis, Colm Andrews, Louis Fisher, Lisa Hopcroft, Christopher T Rentsch, Viyaasan Mahalingasivam, Laurie Tomlinson, Caroline Morton, Miriam Samuel, Amelia Green, Christopher Wood, Andrew D Brown, Jon Massey, Caroline Walters, Rebecca M Smith, Peter Inglesby, David Evans, Steven Maude, Iain Dillingham, Alex J Walker, Jessica Morley, Amir Mehrkar, Seb Bacon, Chris Bates, Jonathan Cockburn, John Parry, Frank Hester, Richard J McManus, Ben Goldacre, Brian MacKenna","doi":"10.1136/openhrt-2024-002732","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted cardiovascular disease management in primary care in England.</p><p><strong>Objective: </strong>To describe the impact of the pandemic on blood pressure screening and hypertension management based on a national quality of care scheme (Quality and Outcomes Framework, QOF) across key demographic, regional and clinical subgroups.</p><p><strong>Methods: </strong>With NHS England approval, a population-based cohort study was conducted using OpenSAFELY-TPP on 25.2 million NHS patients registered at general practices (March 2019 to March 2023). We examined monthly changes in recorded blood pressure screening in the preceding 5 years in patients aged ≥45 years and recorded the hypertension prevalence and the percentage of patients treated to target (≤140/90 mmHg for patients aged ≤79 years and ≤150/90 mmHg for patients aged ≥80 years) in the preceding 12 months.</p><p><strong>Results: </strong>The percentage of patients aged ≥45 years who had blood pressure screening recorded in the preceding 5 years decreased from 90% (March 2019) to 85% (March 2023). Recorded hypertension prevalence was relatively stable at 15% throughout the study period. The percentage of patients with a record of hypertension treated to target in the preceding 12 months reduced from a maximum of 71% (March 2020) to a minimum of 47% (February 2021) in patients aged ≤79 years and from 85% (March 2020) to a minimum of 58% (February 2021) in patients aged ≥80 years before recovery. Blood pressure screening rates in the preceding 5 years remained stable in older people, patients with recorded learning disability or care home status.</p><p><strong>Conclusions: </strong>The pandemic substantially disrupted hypertension management QOF indicators, which is likely attributable to general reductions of blood pressure measurement including screening. OpenSAFELY can be used to continuously monitor changes in national quality-of-care schemes to identify changes in key clinical subgroups early and support prioritisation of recovery from care disrupted by COVID-19.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"11 2","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of COVID-19 on recorded blood pressure screening and hypertension management in England: an analysis of monthly changes in the quality and outcomes framework indicators in OpenSAFELY.\",\"authors\":\"Milan Wiedemann, Victoria Speed, Christine Cunningham, Rose Higgins, Helen J Curtis, Colm Andrews, Louis Fisher, Lisa Hopcroft, Christopher T Rentsch, Viyaasan Mahalingasivam, Laurie Tomlinson, Caroline Morton, Miriam Samuel, Amelia Green, Christopher Wood, Andrew D Brown, Jon Massey, Caroline Walters, Rebecca M Smith, Peter Inglesby, David Evans, Steven Maude, Iain Dillingham, Alex J Walker, Jessica Morley, Amir Mehrkar, Seb Bacon, Chris Bates, Jonathan Cockburn, John Parry, Frank Hester, Richard J McManus, Ben Goldacre, Brian MacKenna\",\"doi\":\"10.1136/openhrt-2024-002732\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The COVID-19 pandemic disrupted cardiovascular disease management in primary care in England.</p><p><strong>Objective: </strong>To describe the impact of the pandemic on blood pressure screening and hypertension management based on a national quality of care scheme (Quality and Outcomes Framework, QOF) across key demographic, regional and clinical subgroups.</p><p><strong>Methods: </strong>With NHS England approval, a population-based cohort study was conducted using OpenSAFELY-TPP on 25.2 million NHS patients registered at general practices (March 2019 to March 2023). We examined monthly changes in recorded blood pressure screening in the preceding 5 years in patients aged ≥45 years and recorded the hypertension prevalence and the percentage of patients treated to target (≤140/90 mmHg for patients aged ≤79 years and ≤150/90 mmHg for patients aged ≥80 years) in the preceding 12 months.</p><p><strong>Results: </strong>The percentage of patients aged ≥45 years who had blood pressure screening recorded in the preceding 5 years decreased from 90% (March 2019) to 85% (March 2023). Recorded hypertension prevalence was relatively stable at 15% throughout the study period. The percentage of patients with a record of hypertension treated to target in the preceding 12 months reduced from a maximum of 71% (March 2020) to a minimum of 47% (February 2021) in patients aged ≤79 years and from 85% (March 2020) to a minimum of 58% (February 2021) in patients aged ≥80 years before recovery. Blood pressure screening rates in the preceding 5 years remained stable in older people, patients with recorded learning disability or care home status.</p><p><strong>Conclusions: </strong>The pandemic substantially disrupted hypertension management QOF indicators, which is likely attributable to general reductions of blood pressure measurement including screening. OpenSAFELY can be used to continuously monitor changes in national quality-of-care schemes to identify changes in key clinical subgroups early and support prioritisation of recovery from care disrupted by COVID-19.</p>\",\"PeriodicalId\":19505,\"journal\":{\"name\":\"Open Heart\",\"volume\":\"11 2\",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Heart\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/openhrt-2024-002732\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Heart","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/openhrt-2024-002732","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Impact of COVID-19 on recorded blood pressure screening and hypertension management in England: an analysis of monthly changes in the quality and outcomes framework indicators in OpenSAFELY.
Background: The COVID-19 pandemic disrupted cardiovascular disease management in primary care in England.
Objective: To describe the impact of the pandemic on blood pressure screening and hypertension management based on a national quality of care scheme (Quality and Outcomes Framework, QOF) across key demographic, regional and clinical subgroups.
Methods: With NHS England approval, a population-based cohort study was conducted using OpenSAFELY-TPP on 25.2 million NHS patients registered at general practices (March 2019 to March 2023). We examined monthly changes in recorded blood pressure screening in the preceding 5 years in patients aged ≥45 years and recorded the hypertension prevalence and the percentage of patients treated to target (≤140/90 mmHg for patients aged ≤79 years and ≤150/90 mmHg for patients aged ≥80 years) in the preceding 12 months.
Results: The percentage of patients aged ≥45 years who had blood pressure screening recorded in the preceding 5 years decreased from 90% (March 2019) to 85% (March 2023). Recorded hypertension prevalence was relatively stable at 15% throughout the study period. The percentage of patients with a record of hypertension treated to target in the preceding 12 months reduced from a maximum of 71% (March 2020) to a minimum of 47% (February 2021) in patients aged ≤79 years and from 85% (March 2020) to a minimum of 58% (February 2021) in patients aged ≥80 years before recovery. Blood pressure screening rates in the preceding 5 years remained stable in older people, patients with recorded learning disability or care home status.
Conclusions: The pandemic substantially disrupted hypertension management QOF indicators, which is likely attributable to general reductions of blood pressure measurement including screening. OpenSAFELY can be used to continuously monitor changes in national quality-of-care schemes to identify changes in key clinical subgroups early and support prioritisation of recovery from care disrupted by COVID-19.
期刊介绍：
Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
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