Hypertension, commonly known as high blood pressure, is one of the leading killers; especially in African Americans. Poor diet, stress and lack of exercise are the primary triggers. Kaiser Permanente was able to double the percentage of patients who lowered their pressure. They managed to do this in under a decade by using a system that included cheaper drugs and close monitoring.
During an eight-year study, the percentage of North California patients with healthy blood pressure increased from 44 percent to 80 percent. The rate continued to increase after the study officially ended 2009. By 2011 the percentage had risen to 87. Doctors at Kaiser and other facilities agree that this is so close to perfect it exceeded their expectations.
“We focused on things that make care more convenient to patients – alternatives to the traditional way of patients visiting the doctor, giving them creative options, offering medications that are easy to take and effective,” said Dr. Marc Jaffe, lead author of the high blood pressure study and head of the Kaiser Northern California Cardiovascular Risk Reduction Program. “I’m excited to see how this model plays out” in programs outside of Kaiser, Jaffe said.
Kaiser began their study by first formatting a list of all Northern California members who were diagnosed with high blood pressure. High blood pressure is any reading above 140 over 90.
After the creation of the registry, Kaiser established a method for giving feedback to physicians concerning their patients. They also instituted a new system which would allow these patients to visit medical assistants, instead of doctors, to get their pressure checked regularly. This would eliminate the cost associated with seeing an actual doctor as well as the inconvenience of having to wait in a doctor’s office or for an appointment.
Midway throughout the program Kaiser switched medication to a generic pill that consisted of two common blood pressure drugs. This pill was less expensive and easier to swallow; eliminating the need to take separate pills. They felt the patients would be more apt to stick with the program that way.
People all over the world have struggled to gain control of their blood pressure for many decades. In the United States hypertension affects close to 65 million adults. High blood pressure is the main cause of cardiovascular disease and contributes greatly to heart attacks and strokes. Kaiser Permanente has developed a system that will help many people who have suffered from hypertension. Over the course of this study the number of heart attacks and strokes fell substantially.
Doctors have treated patients with this disease primarily through exercise, proper diet, reduced stress, and of course, medication. But high blood pressure requires patients to make lifestyle changes which include daily medications; many have found this difficult.
One member of the study, Dr. Don Conkling, finally managed to get his blood pressure into a normal, healthy range for the first time since his early 40s. Conkling lost about 60 pounds; he removed sugar and meat from his diet. He also incorporated walking miles several times a day with his dog. Conkling, a 63-year-old veterinarian in San Bruno, now meditates every day in order to reduce stress.
Cockling said he had been aware that his blood pressure was an issue for many years. He credits this victory to being part of a team and having accountability checks and balances. He said he needed someone not only to tell him it needed to be fixed but that the ability to fix was well within his power to do.
In less than one decade, Kaiser Permanente was able to double the percentage and get people on their way to a healthier lifestyle just by creating a system with accountability and cheaper, more efficient drugs.
By: Cherese Jackson (Virginia)