Differences in BP control using NICE guidelines and QOF targets

High blood pressure is the main risk factor for cardiovascular disease. As cardiovascular risk is directly associated with blood pressure levels, the aim of interventions is to lower blood pressure. This aim results in a definition of the control of blood pressure which is currently understood as an achievement of specific blood pressure levels or targets. These targets have been established in different guidelines based on the consensus views of experts. In a study published in JRSM Short Reports, Lena Barrera and colleagues compared differences in the classification of hypertensive controlled patients between the quality indicator established in QOF guidance and the clinical target recommended in NICE guidelines using data from general practices in London.

They found that 80% of patients were classified as controlled by the QOF target and 1% by the NICE target. 93% and 14% of practices had more than 70% of patients classified as controlled using the QOF and NICE targets respectively. Using the QOF target, men aged 45–64 years and 65 years and over had significantly higher probability of being classified as controlled compared to those aged 17–44 years. Lena Barrera and colleagues concluded that better achievement of blood pressure control targets is present when the less stringent QOF target is used and that greater consistency is needed between the clinical targets in QOF and NICE guidance.

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