Abstract
Introduction
Hypertension is often incidentally discovered in the emergency department (ED); these patients may benefit from close follow-up. We developed a module to automatically include discharge instructions for patients with elevated blood pressure (BP) in the ED, aiming to improve 30-day follow-up.
Aim
This study sought to determine if automated discharge instructions for patients with elevated blood pressure in the ED improved 30-day follow-up with a patient’s primary care physician (PCP).
Methods
We developed an automated module with standardized instructions for patients with elevated BP. These were read upon discharge, and e-mailed to the PCP. We analyzed 193 patients during a 1-month interval after implementation, and 207 during 1-month the year prior. The groups were compared using Fisher’s exact test.
Results
Thirty-day follow-up was 52.2% pre-implementation and 48.4% post-implementation, with no significant difference noted. For patients without known hypertension, follow-up slightly improved, but not significantly. For hypertensive patients, follow-up rates significantly decreased post-implementation.
Conclusions
Despite implementation of automated discharge instructions, we found no improvement in 30-day follow-up. Patients without hypertension trended towards improved follow-up, possibly being more attentive to new abnormal BP readings. However, known hypertensive patients followed-up at a lower rate, which was unexpected and requires further investigation.
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Funding
No funding was received to assist with the preparation of this manuscript.
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On behalf of all authors, the corresponding author states that there are no conflicts of interest.
Ethics approval
This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Beth Israel Deaconess Medical Center approved this study.
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Chiu, D.T., Stenson, B.A., Nathanson, L.A. et al. Use of an Automated Discharge Instruction Module to Improve Outpatient Follow-Up for Emergency Department Patients with Elevated Blood Pressure. High Blood Press Cardiovasc Prev 29, 481–485 (2022). https://doi.org/10.1007/s40292-022-00533-6
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DOI: https://doi.org/10.1007/s40292-022-00533-6