Provider Adherence to the JNC 8 Guidelines in an Integrated Primary Care and Behavioral Health Setting
Problem: A significant number of individuals have uncontrolled hypertension despite receiving antihypertensive therapy. This has been attributed, in part, to the lack of provider adherence to the clinical guidelines. Purpose: The objective of this project was to evaluate provider adherence to the Eighth Joint National Committee (JNC 8) guidelines for the management of hypertension in patients at a community primary care center co-located within a behavioral medicine practice. Theory: Stokols’ (1992) Social Ecology Model for Health Promotion guided this project. Methods: An exploratory retrospective chart review was conducted. Adherence rates were analyzed using descriptive statistics, Pearson’s chi-square tests, and independent t-tests. Results: Provider adherence rate to the JNC 8 guidelines for intensification of therapy was 60.3%, with an 84.4% adherence rate to the guidelines for medication class. No significant difference was found between provider adherence rates between care groups. Implications to Practice: Provider factors which contribute to clinical inertia in the treatment of hypertension in integrated care settings must be addressed to improve clinical outcomes. Further research which examines provider and patient factors that impede management of hypertension is necessary.