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(Hypertension. 2004;44:602.)
© 2004 American Heart Association, Inc.

Brief Reviews

Measuring Adherence to Practice Guidelines for the Management of Hypertension

An Evaluation of the Literature

From the Division of Clinical and Administrative Pharmacy (J.L.M., B.L.C., G.A.), College of Pharmacy, University of Iowa, and the Department of Family Medicine (B.L.C., P.A.J., G.A.), Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City.

Correspondence to Barry L. Carter, PharmD, Professor and Head, Division of Clinical and Administrative Pharmacy, College of Pharmacy, Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242. E-mail barry-carter{at}uiowa.edu

Adherence to practice guidelines is frequently used as a measure of quality of care. Numerous studies have evaluated physician adherence to hypertension guidelines by prescription data, physician survey data, or medical record review. However, most have methodological limitations that might underestimate physician adherence. Accurate and meaningful characterization of adherence rests on evaluation of varied components of hypertension care, use of explicit validated performance measures, incorporation of implicit and explicit review, and linkage of process measures to blood pressure outcomes.

Key Words: hypertension, detection and control • population • lifestyle • epidemiology

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