Table 1.
Adherence Scores* for Selected Blood Pressure Performance and Process Metrics among Liver Transplant Recipients, 2010–2016
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | |
|---|---|---|---|---|---|---|
| Total Eligible LTRs | 602 | 542 | 451 | 353 | 255 | 160 |
| LTR with BP measured at least yearly after transplant | 100.0% | 94.8% | 87.4% | 83.3% | 76.5% | 80.0% |
| 602/602* | 514/542 | 394/451 | 294/353 | 195/255 | 128/160 | |
| LTR with SBP ≥ 140 or DBP ≥ 90 mmHg, and who had BP reassessed within 1 month after elevated reading | 35.6% | 41.8% | 34.6% | 35.6% | 37.0% | 42.0% |
| 180/505 | 167/400 | 110/318 | 89/250 | 67/181 | 50/119 | |
| LTR with SBP ≥140 or DBP ≥90 mmHg, and who had a BP-lowering agent offered | 41.8% | 22.4% | 19.4% | 20.9% | 13.3% | 16.2% |
| 211/505 | 88/393 | 57/294 | 46/220 | 20/150 | 19/117 | |
| LTR with diagnosis of HTN, and who had a BP-lowering agent offered | 37.0% | 40.1% | 34.0% | 34.6% | 34.5% | 41.7% |
| 198/535 | 196/489 | 139/409 | 112/324 | 82/238 | 63/151 | |
| LTR with diagnosis of CKD and SBP ≥ 130 or DBP ≥ 80 mmHg, and who had a BP-lowering agent offered | 37.2% | 40.3% | 36.1% | 35.7% | 35.9% | 43.4% |
| 160/430 | 155/385 | 114/316 | 90/252 | 69/192 | 53/122 | |
| LTR with diagnosis of DM and SBP ≥ 130 or DBP ≥ 80 mmHg, and who had a BP-lowering agent offered | 35.2% | 44.1% | 40.7% | 38.7% | 39.7% | 48.7% |
| 102/290 | 115/261 | 85/209 | 63/163 | 50/126 | 38/78 | |
| LTR with diagnosis of HTN and CKD, and who had an ACEI or ARB offered | 9.0% | 8.4% | 7.5% | 8.8% | 8.8% | 14.1% |
| 37/412 | 33/391 | 25/332 | 24/272 | 18/205 | 19/135 | |
| LTR with BP controlled to SBP <140 and DBP <90 mmHg | 16.1% | 26.2% | 29.5% | 29.2% | 29.0% | 25.6% |
| 97/602 | 142/542 | 133/451 | 103/353 | 74/255 | 41/160 | |
| LTR with BP controlled to SBP <130 and DBP <80 mmHg | 5.0% | 10.0% | 12.9% | 13.0% | 11.0% | 13.8% |
| 30/602 | 54/542 | 58/451 | 46/353 | 28/255 | 22/160 | |
| LTR with diagnosis of HTN and in whom BP was controlled to SBP <140 and DBP <90 mmHg | 10.1% | 21.5% | 26.7% | 28.1% | 26.5% | 25.2% |
| 54/535 | 105/489 | 109/409 | 91/324 | 63/238 | 38/151 | |
| LTR with diagnosis of HTN and in whom BP was controlled to SBP <130 and DBP <80 mmHg | 3.0% | 6.7% | 10.0% | 11.7% | 8.4% | 13.2% |
| 16/535 | 33/489 | 41/409 | 38/324 | 20/238 | 20/151 | |
| LTR with diagnosis of CKD and in whom BP was controlled to SBP < 130 and DBP <80 mmHg | 3.4% | 7.0% | 9.7% | 11.9% | 9.9% | 12.2% |
| 15/445 | 29/414 | 34/350 | 34/286 | 21/213 | 17/139 | |
| LTR with diagnosis of HTN and CKD and in whom BP was controlled to SBP < 130 and DBP <80 mmHg | 2.9% | 6.1% | 8.7% | 11.0% | 8.8% | 11.9% |
| 12/412 | 24/391 | 29/332 | 30/272 | 18/205 | 16/135 | |
| LTR with diagnosis of DM and in whom blood pressure was controlled to SBP < 130 and DBP <80 mmHg | 3.7% | 7.8% | 8.3% | 6.3% | 7.4% | 13.3% |
| 11/301 | 22/283 | 19/228 | 11/174 | 10/136 | 12/90 | |
| LTR with diagnosis of HTN and DM and in whom BP was controlled to SBP < 130 and DBP <80mmHg | 2.5% | 6.1% | 6.6% | 6.1% | 4.6% | 12.6% |
| 7/282 | 16/264 | 14/213 | 10/164 | 6/130 | 11/87 | |
| LTR with a diagnosis of coronary artery disease and BP <140/90 mmHg, or LTR with BP ≥ 140/90 mmHg who were prescribed ≥ 2 BP-lowering medications | 23.6% | 23.3% | 16.3% | 15.9% | 17.7% | 14.0% |
| 124/526 | 104/447 | 59/361 | 45/283 | 37/209 | 19/136 | |
| LTR with diagnosis of HTN and in whom goal BP (SBP < 140 and DBP < 90 mmHg) was not achieved, who then were offered referral to a HTN specialist** | 32.6% | 20.6% | 19.7% | 19.3% | 17.1% | 15.0% |
| 140/481 | 76/384 | 51/300 | 42/233 | 27/175 | 16/113 | |
| LTRs with diagnosis of HTN who are on at least 2 or more BP-lowering agents and in whom goal BP (SBP < 140 and DBP < 90 mmHg) was not achieved, who were then offered referral to a HTN specialist** | 35.5% | 38.8% | 36.4% | 35.0% | 26.5% | 46.7% |
| 43/121 | 38/98 | 20/55 | 14/40 | 9/34 | 7/15 | |
Abbreviations: LTR, liver transplant recipient; BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; HTN, hypertension; CKD, chronic kidney disease; DM, diabetes mellitus; ACEI, angiotension converting enzyme inhibitor; ARB, angiotension receptor blocker
*
Adherence score = number of liver transplant recipients who received the intervention divided by the total number of eligible liver transplant recipients for the intervention X 100.
**
HTN specialist is defined as a cardiologist or nephrologist