ArticleArthritis care & research2019
Connecting Rheumatology Patients to Primary Care for High Blood Pressure: Specialty Clinic Protocol Improves Follow-up and Population Blood Pressures.
Article in Arthritis care & research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Learning health systems using data to drive healthcare improvement and impact: a systematic review.BMC health services research · 2021Pooled it
- Article
- Low adherence to cardiovascular risk assessment guidelines in patients with rheumatoid arthritis: a retrospective chart review of routine clinical practice.Rheumatology international · 2025Review
- Cardiovascular disease risk assessment in patients with rheumatoid arthritis: A scoping review.Clinical rheumatology · 2024Article
- Multimorbidity in Rheumatoid Arthritis: Literature Review and Future Directions.Current rheumatology reports · 2024Review
- Improving primary care follow-up for gynecologic patients with hypertension: an implementation science pilot study.American journal of obstetrics and gynecology · 2022Article
- Impact of a Rheumatology Clinic Protocol on Tobacco Cessation Quit Line Referrals.Arthritis care & research · 2022Article
- Significant Gains in Rheumatoid Arthritis Quality Measures Among RISE Registry Practices.Arthritis care & research · 2022Article
- Interactive and Participatory Audit and Feedback (IPAF): theory-based development and multi-site implementation outcomes with specialty clinic staff.Implementation science communications · 2021Article
- Patient Perception of Cardiovascular Risk in Rheumatoid Arthritis.ACR open rheumatology · 2020Article
- Outreach to Promote Management of Cardiovascular Risk in Primary Care Among Patients With Rheumatoid Arthritis Seen in Rheumatology Practice.ACR open rheumatology · 2020Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectiveRecognizing high blood pressure (BP) as the most prevalent cardiovascular risk factor in patients with rheumatic diseases and all adults, experts recommend clinic protocols to improve BP control. The aim of this study was to adapt and implement a specialty clinic protocol, "BP Connect," to improve timely primary care follow-up after high BP measurements in rheumatology clinics.
methodsWe examined BP Connect in a 6-month preimplementation and postimplementation quasi-experimental design with 24-month follow-up in 3 academic rheumatology clinics. Medical assistants and nurses were trained to 1) check (re-measuring BPs ≥140/90 mm Hg), 2) advise (linking rheumatic and cardiovascular diseases), and 3) connect (timely [<4 weeks] primary care follow-up using protocoled electronic health record [EHR] orders). We used EHR data and multivariable logistic regression analysis to examine the primary outcome of timely primary care follow-up for patients with in-network primary care. Staff surveys were used to assess perceptions. Interrupted time series analysis was performed to examine sustainability and BP trends in the clinic populations.
resultsAcross both 4,683 preimplementation and 689 postimplementation rheumatology visits by patients with high BP, 2,789 (57%) encounters were eligible for in-network primary care follow-up. Postimplementation, the odds of timely primary care BP measurement follow-up doubled (odds ratio 2.0, 95% confidence interval 1.4-2.9). Median time to follow-up decreased from 71 days to 38 days. Moreover, rheumatology visits by patients with high BP decreased from 17% to 8% over 24 months, suggesting significant population-level declines (P < 0.01).
conclusionImplementing the BP Connect specialty clinic protocol in rheumatology clinics improved timely follow-up and demonstrated reduced population-level rates of high BP. These findings highlight a timely strategy to improve BP follow-up amid new guidelines and quality measures.
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