Family Physicians' Quality Interventions and Performance Improvement for Hypertension through Maintenance of Certification

J Healthc Qual. 2016 May-Jun;38(3):175-86. doi: 10.1111/jhq.12082.


Purpose: Hypertension is a cause of considerable morbidity and mortality. Our objective was to describe the quality outcomes associated with physicians' completion of hypertension Performance in Practice Modules (PPMs) as part of Maintenance of Certification (MOC).

Methods: Descriptive study of all hypertension PPMs completed by family physicians from July 2006 to 2013. Descriptive statistics characterized physician demographics and quality outcomes; linear regression determined characteristics associated with improvement.

Results: In total, 7,319 hypertension PPMs were completed by family physicians that had a mean age of 47.9 years and 14.2 years of practice experience. Most (52.4%) chose lipid control as their quality improvement (QI) focus. Performance on all quality measures improved except mean low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol values; however, percentage of patients with LDL < 130 mg/dl improved. Improvement was seen in blood pressure control (87.4% to 92.6%, p < .05), low sodium diet counseling (74.1% to 92.7%, p < .05), and exercise counseling (82.4% to 94.4%, p < .05). In regression models, no variable was consistently associated with improvement.

Discussion: Family physicians improved the quality of care for patients with hypertension through MOC. Leveraging MOC across all specialties may become an important support for improving management of conditions that cause considerable morbidity and mortality.

MeSH terms

  • Certification*
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Physicians, Family*
  • Primary Health Care
  • Quality Improvement*
  • Quality of Health Care / standards*