Cardiovascular Risk and Blood Pressure Control in Patients with Diabetes at Federally Qualified Health Centers: Baseline Findings from the Office-GAP IMPACT (Office-Guidelines Applied to Practice Improving Diabetic Patients’ Adherence to Treatment and Prevention of Cardiovascular Disease) Program
摘要
The rate of diabetes and blood pressure (BP) control are low, particularly in patients with diabetes receiving care from federally qualified health centers (FQHCs). The Office-Gap IMPACT study (Office-Guidelines Applied to Practice Improving Diabetic Patients’ Adherence to Treatment and Prevention of Cardiovascular Disease) is a patient activation intervention to improve care and health outcomes for patient with diabetes and cardiovascular disease in FQHCs and community health centers.
ObjectivesThis baseline analysis of the Office-GAP IMPACT study (1) aimed to describe the individual-level demographic and clinical characteristics of patients with diabetes enrolled in the Office-GAP study, (2) assess the associations between these characteristics and baseline BP and glycemic control, and (3) assess the differences in BP and glycemic control in three different counties in Michigan.
MethodsWe enrolled 392 patients with diabetes in 17 clinical teams in 12 FQHCs located in three counties in Michigan. Teams were randomized into intervention, Office-Gap + Texting (group 1) vs. enhanced control, Texting only (group 2). Baseline demographic and clinical data were analyzed.
ResultsAmong 392 patients, 68% had self-reported hypertension, 72% had hyperlipidemia, 30% had BMI < 30, 26% were current smokers, and 43% reported depression. Overall, 64% had HbA1c ≥ 9. Among those with hypertension, 26% achieved BP < 130/80 mmHg and 60% achieved BP < 140/90 mmHg.
ConclusionPatients with diabetes receiving medical care at FQHCs are a diverse demographic population. The high prevalence of cardiovascular disease risk factors and the low rate of BP control in this demographic is a huge concern.