Improving Pediatric Hypertension Using Population Health

Authors

Abbas H. Zaidi, MD, FAAP, FACC, Thomas Jefferson UniversityFollow

Document Type

Presentation

Presentation Date

7-10-2024

Comments

Presentation: 41:34

Abstract

Importance: Despite published guidelines and a prevalence of pediatric hypertension of around 3%, less than 25% of affected children are identified, with 60% not receiving any intervention despite detection. Understanding the knowledge and perceptions of parents/caregivers and healthcare team may contribute to these unacceptably low detection rates is crucial.

Objective: Explored the knowledge and perceptions of parents and healthcare team to identify common themes contributing to low hypertension detection

Design: Qualitative interviews guided by the Consolidated Framework for Implementation Research

Setting: Multisite pediatric healthcare system in Delaware and Pennsylvania

Participants: 38 stakeholders including 13 parents of children diagnosed with hypertension who did not follow up after diagnosis and 25 multidisciplinary healthcare team members (medical assistances, nurses, managers, pediatricians, nurse practitioners, and doctors).

Exposures:

Main Outcomes & Measures: Data analysis followed an inductive thematic approach, with iterative code development and identification of themes by content and qualitative research experts.

Results: The parent sample was diverse based on race (62% non-White), ethnicity (38% Hispanic), and child opportunity index (38% very low/low). Parents and providers demonstrated awareness of the significance of pediatric hypertension. Parents prioritized blood pressure checks during annual physicals, though providers sometimes downplayed concerns due to competing priorities. Both groups expressed skepticism toward high blood pressure readings, attributing them to situational factors or “white coat syndrome.” Parents and providers shared concerns about medication use and preferred lifestyle change. Parents advocated for further testing, whereas providers exhibited varying perspectives on additional diagnostics, emphasizing targeted testing strategies and cautious medication approaches.

Conclusions & Relevance: Exploring better measurement tools and diagnostic strategies, reassurance around medication use, and communicating the centrality of non-pharmacologic treatments if hypertension is identified might improve detection. Future interventions should consider perspectives from both groups to develop practical strategies for improving pediatric hypertension detection and management.

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Language

English