To examine adherence to guideline‐concordant hypertension treatment practices at community health centers (s) compared with private physicians' offices.
Data Sources/Study Setting
National Ambulatory Medical Care Survey from 2006 to 2010.
We examined four guideline‐concordant treatment practices: initiation of a new medication for uncontrolled hypertension, use of fixed‐dose combination drugs for patients on multiple antihypertensive medications, use of thiazide diuretics among patients with uncontrolled hypertension on ≥3 antihypertensive medications, and use of aldosterone antagonist for resistant hypertension, comparing use at with private physicians' offices overall and by payer group.
Data Collection/Extraction Methods
We identified visits of nonpregnant adults with hypertension at s and private physicians' offices.
Medicaid patients at s were as likely as privately insured individuals to receive a new medication for uncontrolled hypertension ( 1.0, 95 percent : 0.6–1.9), whereas Medicaid patients at private physicians' offices were less likely to receive a new medication ( 0.3, 95 percent : 0.1–0.6). Use of fixed‐dose combination drugs was lower at s ( 0.6, 95 percent : 0.4–0.9). Thiazide use for patients was similar in both settings ( 0.8, 95 percent : 0.4–1.7). Use of aldosterone antagonists was too rare (2.1 percent at s and 1.5 percent at private clinics) to allow for statistically reliable comparisons.
Increasing physician use of fixed‐dose combination drugs may be particularly helpful in improving hypertension control at s where there are higher rates of uncontrolled hypertension.
