Core Concepts
Effective use of electronic health records can significantly improve primary aldosteronism screening rates, leading to better patient outcomes.
Abstract
Overview
Primary aldosteronism (PA) is a common yet often overlooked cause of secondary hypertension. A study conducted by Adina F. Turcu and her team at the University of Michigan Health aimed to improve PA screening rates using a best-practice advisory (BPA) integrated into the electronic health record system.
Key Highlights
Only 4% of at-risk patients receive recommended PA screening.
Turcu's team developed a BPA to identify high-risk patients for PA screening.
The BPA led to a significant increase in PA screening rates, especially among primary care physicians.
Over 14,000 unique candidates for PA screening were identified, with various risk factors.
Physician specialty influenced the utilization of the BPA, with internists and family medicine physicians leading screening orders.
Patients who underwent screening were more likely to be women, Black, and younger than 35 years.
Noninterruptive BPAs integrated into primary care workflows show promise in improving PA awareness and diagnosis.
Study Details
15-month quality improvement study conducted in 2023.
Identified candidates had treatment-resistant hypertension, hypokalemia, young age, or adrenal nodules.
14% of candidates received orders for PA screening, with 70.5% completing the screening.
17.4% of screened patients had positive results.
Stats
48.1% of candidates had treatment-resistant hypertension.
43.5% exhibited hypokalemia.
10.5% were younger than 35 years.
3.1% had adrenal nodules.
14% of candidates received orders for PA screening.
70.5% completed the recommended screening.
17.4% received positive screening results.
Quotes
"Although we were hoping for broader uptake of this EHR-embedded BPA, we were delighted to see an increase in PA screening rates..." - Adina F. Turcu
"Primary hyperaldosteronism is a condition that can be treated surgically and has increased long term cardiovascular consequences if not identified." - Kaniksha Desai