Peripheral arterial disease: blood pressure (80 years and over)

Indicator type

General practice indicator suitable for use outside of the Quality and Outcomes Framework.

Rationale

Blood pressure control can help with secondary prevention of cardiovascular disease. Blood pressure targets differ between clinic and home settings because blood pressure can be raised in formal settings such as in clinic. The intermediate outcome can be achieved through lifestyle advice or the use of drug therapy.

Source guidance

Hypertension in adults: diagnosis and management. NICE guideline NG136 (2019, updated 2023), recommendations 1.4.21 to 1.4.23

Specification

Numerator: The number of patients in the denominator in whom the last blood pressure reading (measured in the preceding 12 months) is less than 145/85 mmHg if using ambulatory or home monitoring, or less than 150/90 mmHg if monitored in clinic.

Denominator: The number of patients aged 80 years or over on the peripheral arterial disease register.

Calculation: (Numerator/denominator)*100

Exclusions: None.

Personalised care adjustments or exception reporting should be considered to account for situations when patients decline to have blood pressure recorded or when the target is not appropriate.

Minimum population: The indicator would be appropriate to assess performance at individual general practice level outside the QOF. To be classified as suitable for use in QOF, there should be an average minimum population of more than 20 patients per practice eligible for inclusion in the denominator prior to application of personalised care adjustments. Piloting for the original indicator NM67 estimated that 30% of the peripheral arterial disease register would be people 80 years or over. QOF 2020 to 2021 data shows a peripheral arterial disease prevalence of 0.59% which would equate to 46 patients in an average practice of 10,000 patients. If 30% are 80 years or over, this equates to 14 patients per practice.

ISBN: 978-1-4731-5795-8