Using electronic patient records to inform strategic decision making in primary care.

Elizabeth Mitchell (Lead / Corresponding author), Frank Sullivan, Graham Watt, Jeremy M. Grimshaw, Peter T. Donnan

    Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)peer-review

    4 Citations (Scopus)


    Although absolute risk of death associated with raised blood pressure increases with age, the benefits of treatment are greater in elderly patients. Despite this, the 'rule of halves' particularly applies to this group. We conducted a randomised controlled trial to evaluate different levels of feedback designed to improve identification, treatment and control of elderly hypertensives. Fifty-two general practices were randomly allocated to either: Control (n=19), Audit only feedback (n=16) or Audit plus Strategic feedback, prioritising patients by absolute risk (n=17). Feedback was based on electronic data, annually extracted from practice computer systems. Data were collected for 265,572 patients, 30,345 aged 65-79. The proportion of known hypertensives in each group with BP recorded increased over the study period and the numbers of untreated and uncontrolled patients reduced. There was a significant difference in mean systolic pressure between the Audit plus Strategic and Audit only groups and significantly greater control in the Audit plus Strategic group. Providing patient-specific practice feedback can impact on identification and management of hypertension in the elderly and produce a significant increase in control.

    Original languageEnglish
    Title of host publicationMEDINFO 2004
    Subtitle of host publicationProceedings of the 11th World Congress on Medical Informatics
    EditorsMarius Fieschi, Enrico Coiera, Yu-.Chan Jack Li
    Place of PublicationAmsterdam
    PublisherIOS Press
    Number of pages5
    VolumePart 1
    ISBN (Electronic)9781607509493
    ISBN (Print)9781586034443
    Publication statusPublished - Aug 2004

    Publication series

    NameStudies in Health Technology and Informatics
    PublisherIOS Press


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