In a recent article in Public Health Reports, Drs. Madeleine M. Baker-Goering, Julie C. Will, Garrett R. Beeler Asay, and Kakoli Roy of the Centers of Disease Control and Prevention (CDC) and Dr. David H. Howard of Emory University examined if patients whose insurance claims included an International Classification of Diseases, Ninth Revision (ICD-9) code associated with hypertension, who self-reported high blood pressure, were likelier to fill antihypertensive medication prescriptions and less likely to have Cardiovascular disease (CVD)-related emergency department visits and hospitalizations (CVD-related events) and related medical expenditures than patients with these codes who did not self-report high blood pressure. A large convenience sample was used from the MarketScan Commercial Database linked with the MarketScan Health Risk Assessment (HRA) Database to identify patients aged 18-64 in the U.S. whose insurance claims included an ICD-9 code associated with hypertension and who completed an HRA from 2008 through 2012.
A multivariate logistic regression analysis was also used to examine the association between self-reported high blood pressure and (1) filling prescriptions for antihypertensive medications and (2) CVD-related events. A 2-part model was used to analyze medical expenditures since most patients with hypertension will not have a CVD-related event. The first part estimated the likelihood of a CVD-related event, and the second part estimated expenditures. Results indicated that patients with an ICD-9 code of hypertension who self-reported high blood pressure had a significantly higher predicted probability of filling antihypertensive medication prescriptions, had a significantly lower predicted probability of a CVD-related event, and on average spent significantly less on CVD-related events than patients who did not self-report high blood pressure.
The authors concluded that self-knowledge of high blood pressure, even among patients who are diagnosed and treated for hypertension, can be improved. Moreover, interventions that improve patients’ awareness of their hypertension may improve antihypertensive medication use and reduce adverse CVD-related events.
Public Health Reports (PHR) is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. The journal is peer-reviewed and publishes original research, reviews, and commentaries in the areas of public health practice and methodology, original research, public health law, and teaching at schools and programs of public health schools and teaching. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. PHR’s mission is to facilitate the movement of science into public health practice and policy to positively affect the health and wellness of the American public.
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