Evaluation of the "Follow Your Heart" project: Academic detailing to improve hypertension composite quality measure

Abstract: BACKGROUND: In 2023, the Virtual Integrated Services Network (VISN) 20 of the United States (US) Department of Veterans Affairs (VA) ranked last out of 18 regions in the composite quality health measure goal for veterans with high blood pressure (<140/90 mmHg). OBJECTIVES: Evaluate the impact of academic detailing (AD) on the proportion of veterans with a blood pressure goal of <140/90 mmHg for seven VA medical centers in VISN 20. PRACTICE DESCRIPTION: Implementation of a pharmacist-led, hypertension-focused AD intervention to increase the proportion of veterans meeting blood pressure goal of <140/90 mmHg. PRACTICE INNOVATION: Prioritization of efforts to improve healthcare quality accountability measures and enhance blood pressure management across seven VA medical centers through AD. EVALUATION METHODS: A retrospective quasi-experimental study was conducted to evaluate the impact of the AD intervention on the proportion of veterans with a blood pressure goal of <140/90 mmHg at seven VA medical centers at VISN 20. A single-group interrupted time series analysis was conducted to evaluate the differences in the trends of the proportion of veterans with a blood pressure goal of <140/90 mmHg before and after implementation of the hypertension-focused AD intervention. RESULTS: There was a significantly greater increase in the trend (proportion of veterans with a blood pressure goal <140/90 mmHg) in the period after compared to before the AD intervention by +0.31-percentage points per month (95% CI: 0.18, 0.43) in the pooled cohort of VA medical centers. Moreover, four of the seven VA medical centers had significant increases in the proportion of veterans with a blood pressure goal of <140/90 mmHg in the period after compared to before implementation of the AD intervention. CONCLUSION: A hypertension-focused AD intervention improved the proportion of veterans with a blood pressure goal of <140/90 mmHg at VISN 20.