Published Online
on September 20, 2004

A more recent version of this article appeared on November 1, 2004

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Submitted on June 4, 2004
Revised on June 25, 2004

Measuring Adherence to Practice Guidelines for the Management of Hypertension. An Evaluation of the Literature

Jessica L. Milchak; Barry L. Carter^*; Paul A. James; and Gail Ardery

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.

^* To whom correspondence should be addressed. E-mail: barry-carter{at}uiowa.edu.

Abstract--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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