Automated Screening to Identify Uncontrolled Hypertension Due to Primary Aldosteronism
Maryanne Peifer, MD, MSIS
Daniel Herman, MD, PhD
Jordana Cohen, MD, MSCE
Jesse Passman, MD, MPH
Heather Wachtel, MD
Jasmine Hwang, MD, MS
Hypertension affects nearly 50 percent of adults in the United States. In around 20 percent of cases, hypertension persists even with medication – putting patients at higher risk of cardiovascular disease and mortality. Although primary aldosteronism (PA), an adrenal gland disorder, is the most common cause of treatment-resistant hypertension, PA screening rates for patients remain low.
Screening for and treating PA can improve health outcomes for patients while also enhancing blood pressure control on a population level, which is financially relevant to health systems with value-based contracts.
With support from the Nudge Unit, a team of researchers at the University of Pennsylvania developed an automated approach to make it easier for providers to identify and treat PA. The team created a tool that scans the electronic health record (EHR) for patients with evidence of uncontrolled hypertension. If the criteria are met, the patient’s primary care provider receives an EHR Best Practice Alert recommending they order the lab tests needed for PA diagnosis. The tool also provides diagnostic guidance based on the lab results.
A pilot study testing this intervention is currently underway. Results will be posted here once available.