Wednesday, December 18, 2013

New Guidelines for Hypertension Care

If you or your company are in the business of population health management and your service portfolio includes high blood pressure, you need to download this report.  The JNC 8 Guidelines have been released on-line in JAMA.

They are the best summary that expert science has to offer on the state-of-the-art treatment for hypertension.  There are new thresholds for treatment, new targets that define success and new recommendations on which anti-hypertensives to try first. 

Stakeholders interested in promoting non-medication treatment options may come away disappointed.  After reading through this once, the Disease Management Care Blog found very little in the guidelines on "lifestyle"  The authors instead decided to briefly endorse a separate set of lifestyle guidelines that can be found here.  Good for them.

Unfortunately the JNC 8 guidelines are remarkably light on the well-recognized need to help patients overcome their reluctance to take their medications.  Patients are notorious for not taking their pills as prescribed, the causes for that are well known and better medication adherence translates into lower health care costs that, in studies like this, are statistically and financially significant. This is a whole other art and science that is the "secret sauce" for population health management, where team-based care managers with sophisticated coaching techniques can make a huge difference in key adherence outcomes.

Aside from a few nods to the topic, the JNC 8 authors just didn't have the time or take the effort.  Maybe the JAMA editors didn't have enough space in the journal to include a few paragraphs on the importance of promoting medication adherence.


That's OK, though, because the millions of persons already involved in care management programs nationwide are already being cared for by professionals who are already aware of that need. 

Coda: A next step for JNC 8: getting docs to pay attention to them.  More on that here.

Image from Wikipedia

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