Impact of COVID-19 on recorded blood pressure screening and hypertension management in England: an analysis of monthly changes in the quality and outcomes framework indicators in OpenSAFELY.

BACKGROUND

The COVID-19 pandemic disrupted cardiovascular disease management in primary care in England.

OBJECTIVE

To describe the impact of the pandemic on blood pressure screening and hypertension management based on a national quality of care scheme (Quality and Outcomes Framework, QOF) across key demographic, regional and clinical subgroups.

METHODS

With NHS England approval, a population-based cohort study was conducted using OpenSAFELY-TPP on 25.2 million NHS patients registered at general practices (March 2019 to March 2023). We examined monthly changes in recorded blood pressure screening in the preceding 5 years in patients aged ≥45 years and recorded the hypertension prevalence and the percentage of patients treated to target (≤140/90 mmHg for patients aged ≤79 years and ≤150/90 mmHg for patients aged ≥80 years) in the preceding 12 months.

RESULTS

The percentage of patients aged ≥45 years who had blood pressure screening recorded in the preceding 5 years decreased from 90% (March 2019) to 85% (March 2023). Recorded hypertension prevalence was relatively stable at 15% throughout the study period. The percentage of patients with a record of hypertension treated to target in the preceding 12 months reduced from a maximum of 71% (March 2020) to a minimum of 47% (February 2021) in patients aged ≤79 years and from 85% (March 2020) to a minimum of 58% (February 2021) in patients aged ≥80 years before recovery. Blood pressure screening rates in the preceding 5 years remained stable in older people, patients with recorded learning disability or care home status.

CONCLUSIONS

The pandemic substantially disrupted hypertension management QOF indicators, which is likely attributable to general reductions of blood pressure measurement including screening. OpenSAFELY can be used to continuously monitor changes in national quality-of-care schemes to identify changes in key clinical subgroups early and support prioritisation of recovery from care disrupted by COVID-19.

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare the following: BG has received research funding from the Laura and John Arnold Foundation, the NHS National Institute for Health Research (NIHR), the NIHR School of Primary Care Research, the NIHR Oxford Biomedical Research Centre, the Mohn-Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK, the Health Foundation, the World Health Organisation, UKRI, Asthma UK, the British Lung Foundation and the Longitudinal Health and Wellbeing strand of the National Core Studies programme; he also receives personal income from speaking and writing for lay audiences on the misuse of science.