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dc.contributor.authorGoulding, Melissa
dc.contributor.authorRyan, Grace W
dc.contributor.authorFrisard, Christine
dc.contributor.authorStevens, Elise M
dc.contributor.authorPerson, Sharina D.
dc.contributor.authorGoldberg, Robert J
dc.contributor.authorGarg, Arvin
dc.contributor.authorLemon, Stephenie C
dc.date.accessioned2023-08-15T16:00:48Z
dc.date.available2023-08-15T16:00:48Z
dc.date.issued2023-07-22
dc.identifier.citationGoulding M, Ryan G, Frisard C, Stevens E, Person S, Goldberg R, Garg A, Lemon SC. Pediatric High Blood Pressure Follow-Up Guideline Adherence in a Massachusetts Health Care System. Acad Pediatr. 2024 Apr;24(3):506-513. doi: 10.1016/j.acap.2023.07.006. Epub 2023 Jul 23. PMID: 37487799; PMCID: PMC10803632.en_US
dc.identifier.eissn1876-2867
dc.identifier.doi10.1016/j.acap.2023.07.006en_US
dc.identifier.pmid37487799
dc.identifier.urihttp://hdl.handle.net/20.500.14038/52420
dc.description.abstractObjectives: To describe adherence to the American Academy of Pediatrics' (AAP) 2017 clinical practice guidelines for follow-up after high blood pressure (BP) screening by pediatric and family medicine providers in a Massachusetts healthcare system and to assess differences in receipt of follow-up according to child- and clinic-level factors. Methods: Electronic health record data were analyzed for children aged 3-17 years who had an outpatient primary care visit during 2018 with a high BP screening (according to AAP guidelines). We classified AAP guideline adherent follow-up as BP follow-up within 6 months after an elevated finding (+2-week buffer) and within 2 weeks after a hypertensive finding (+2-week buffer). Differences in receipt of guideline adherent follow-up by child- and clinic-level factors were assessed via multilevel mixed effects logistic regression models. Results: The median age of the 4,563 included children was 12 years and 43% were female. Overall, guideline adherent follow-up was received by 17.7% of children within the recommended time interval; 27.4% for those whose index BP was elevated and 5.4% for those whose BP was hypertensive. Modeling revealed older children and those belonging to clinics with more providers, smaller patient panels, and smaller proportion of Medicaid patients were more likely to receive adherent follow-up. Conclusion: Few children received guideline adherent BP follow-up and most differences in adherence were related to clinic resources. System level interventions are needed to improve BP follow-up.en_US
dc.language.isoenen_US
dc.relation.ispartofAcademic Pediatricsen_US
dc.relation.urlhttps://doi.org/10.1016/j.acap.2023.07.006en_US
dc.rightsCopyright © 2023. Published by Elsevier Inc. Authors' accepted peer-reviewed manuscript posted after 12 months under the CC-BY-NC-ND 4.0 license as allowed by the publisher's author rights policy at https://www.elsevier.com/about/policies-and-standards/sharing.en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectBlood Pressureen_US
dc.subjectGuideline Adherenceen_US
dc.subjectHypertensionen_US
dc.subjectUMCCTS funding
dc.titlePediatric High Blood Pressure Follow-up Guideline Adherence in a Massachusetts Healthcare Systemen_US
dc.typeAccepted Manuscripten_US
dc.source.journaltitleAcademic pediatrics
dc.source.countryUnited States
dc.identifier.journalAcademic pediatrics
dc.contributor.departmentPediatricsen_US
dc.contributor.departmentPopulation and Quantitative Health Sciencesen_US
dc.contributor.departmentPrevention Research Centeren_US
dc.contributor.departmentMorningside Graduate School of Biomedical Sciencesen_US
dc.contributor.departmentBiostatistics and Health Services Researchen_US
dc.contributor.studentMelissa Goulding
dc.description.thesisprogramClinical and Population Health Research


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Copyright © 2023. Published by Elsevier Inc. Authors' accepted peer-reviewed manuscript posted after 12 months under the CC-BY-NC-ND 4.0 license as allowed by the publisher's author rights policy at https://www.elsevier.com/about/policies-and-standards/sharing.
Except where otherwise noted, this item's license is described as Copyright © 2023. Published by Elsevier Inc. Authors' accepted peer-reviewed manuscript posted after 12 months under the CC-BY-NC-ND 4.0 license as allowed by the publisher's author rights policy at https://www.elsevier.com/about/policies-and-standards/sharing.