The Role of Electronic Medical Records in the Identification of Suboptimal Prescribing for Hypertension Management: An Opportunity in Unchanged Therapy

Patel, D., Warren, J. and Kennelly, J.

A Participatory Action Research (PAR) approach was taken to identify electronic medical record (EMR) queries for hypertension management quality review in the context of a Pacific-led New Zealand general practice. In each PAR cycle, queries to identify patients with prescribing at variance from evidence-based practice were formulated and run, relevant patient notes were retrieved, and a quality audit of the medication decisions was carried out by a medical practitioner working in the practice. 764 enrolled and funded patients with current antihypertensive prescriptions were queried regarding adherence to national treatment guidelines. Queries based on drug classes indicated by specific comorbidities (e.g. hypertension complicated by diabetes) retrieved few cases, and with almost none having a compelling case for change in therapy upon review. A query on unchanged therapy while cardiovascular risk (CVR) and systolic blood pressure remained high, however, yielded 30 cases for review, and 10 of these were deemed as warranting further investigation. We conclude that a promising area for the use of EMR queries to improve long-term condition management is in identification of patients with persistently high risk of adverse outcomes and concurrent unchanged therapy during successive general practice visits.

Cite as: Patel, D., Warren, J. and Kennelly, J. (2013). The Role of Electronic Medical Records in the Identification of Suboptimal Prescribing for Hypertension Management: An Opportunity in Unchanged Therapy. In Proc. Health Informatics and Knowledge Management 2013 (HIKM 2013) Adelaide, Australia. CRPIT, 142. Gray, K. and Koronios, A. Eds., ACS. 21-28

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