2025 Southeastern Residency Conference

Title:
Reducing Disparities in Blood Pressure Control Among Female Veterans with Type II Diabetes Mellitus 


Authors:
Victoria Clark, Schylar Hathaway, Marci Swanson, Deborah Hobbs
 
Objective:
Highlight the improvement in equity in hypertension control among female Veterans with diabetes via medication management.
 
Self-Assessment Question:
True/False – Per the ACC/AHA guidelines, the recommended BP target for patients with DM is less than 130/80 mmHg.
 
Background:
A majority of patients with diabetes will have a comorbidity of hypertension which increases risk of cardiovascular disease (CVD), the leading cause of death in women in the U.S. The use of antihypertensives is strongly recommended for both primary and secondary prevention of CVD. Research suggests mixed results on presence of a disparity in blood pressure control among men and women, but reveals older women are less likely to have controlled blood pressure than their male counterparts. This project aims to reduce disparities for female veterans with diabetes mellitus and uncontrolled hypertension via medication management. 


Methods:
This performance improvement project was approved by the P&T Committee. The primary objective aims to improve blood pressure control in female veterans with type II diabetes. The secondary objectives are to increase percentage of female veterans on angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs) and sodium-glucose co-transporter-2 (SGLT-2) inhibitors, if clinically appropriate. The Primary Care Equity Dashboard (PCED) was utilized to identify disparities in blood pressure control. This dashboard was created by using electronic quality measure (eQM) data and provides VISN (Veterans Integrated Services Network) and facility level performance via a disparity matrix. A Clinical Pharmacist Practitioner (CPP) will identify veterans using the following inclusion criteria: females aged 18 to 75, presence of type II diabetes, and blood pressure greater than or equal to 140/90 mmHg at most recent outpatient encounter. The CPP will exclude those with type I diabetes, actively followed by cardiology, no history of primary care provider follow-up within 2 years, receiving hospice/palliative care services, or relocated to outside care. The Computerized Patient Record System (CPRS) was used to review veterans’ charts and determine appropriate antihypertensive therapy for blood pressure control per the 2018 ACC/AHA guidelines.


Results: In Progress


Conclusion: In Progress