Association of continuity of care with blood pressure control in patients with chronic kidney disease and hypertension

Aust J Gen Pract. 2019 May;48(5):300-306. doi: 10.31128/AJGP-05-18-4592.

Abstract

Background and objective: Hypertension frequently co-exists with chronic kidney disease (CKD). The objective of this study was to investigate blood pressure (BP) control among general practice patients with CKD and hypertension, and whether control was related to continuity of care.

Methods: We analysed data from NPS MedicineWise MedicineInsight, examining the achievement of guideline-recommended BP levels in patients with CKD and hypertension, and the relationship with sociodemographic, clinical and health-system variables, including continuity of care (CoC) in general practice.

Results: Of 37,425 patients in the cohort, 46.7% had achieved the recommended BP targets. Patients with higher relational CoC and more general practitioner (GP) visits were more likely to achieve BP targets, while this was less likely when the target was lowered by concomitant diabetes or cardiovascular disease.

Discussion: Reaching BP targets in patients with CKD is a challenge, especially when the target is lower because of co-existing risk factors. Greater CoC from the same GP increased the likelihood of achieving target BP values.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Australia / epidemiology
  • Blood Pressure / physiology*
  • Continuity of Patient Care / standards
  • Continuity of Patient Care / statistics & numerical data
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Primary Health Care / methods
  • Primary Health Care / statistics & numerical data
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Factors

Substances

  • Antihypertensive Agents