C Curtin, L G Bandini, M Forquer, P Cullen, K M Rancaño, A Must, K Schreck, A B Bowling, N Askenazy, X Wei, C Irish, H I Stanish
A remotely-delivered pilot and feasibility program to promote physical and food literacy in adolescents with intellectual disabilities
Journal of applied research in intellectual disabilities : JARID
clinical practice guidelines recommend screening primary hyperaldosteronism ph patients resistant hypertension however screening rates low outpatient setting sought increase screening rates ph patients resistant hypertension veterans affairs va outpatient resident physician clinic goal improving blood pressure control patients possible resistant hypertension identified va primary care almanac metric query subsequent chart review resistant hypertension criteria three sequential patientdirected cycles implemented using rapid cycle improvement methodology weekly dedicated resident quality improvement halfday first cycle patients resistant hypertension preclinic ph screening labs ordered scheduled clinic hypertension followup second cycle patients without screening labs completed called confirm medication adherence counselled screen ph third cycle patients positive screening labs called discuss mineralocorticoid receptor antagonist mra initiation possible endocrinology referral 97 patients initially identified 58 60 found resistant hypertension 39 pseudoresistant hypertension medication nonadherence 58 resistant hypertension 44 previously screened ph 14 24 already screened already taking mra screening rate ph resistant hypertension patients increased 24 start project 84 3744 two cycles 37 tested 24 937 screened positive ph 5 patients started mras residentled quality improvement project demonstrated focused intervention process improve ph identification treatment