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Association of guideline and policy changes with incidence of lifestyle advice and treatment for uncomplicated mild hypertension in primary care: a longitudinal cohort study in the Clinical Practice…

Overview of attention for article published in BMJ Open, September 2018
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • High Attention Score compared to outputs of the same age and source (86th percentile)

Mentioned by

blogs
1 blog
policy
1 policy source
twitter
15 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
2 Dimensions

Readers on

mendeley
22 Mendeley
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Title
Association of guideline and policy changes with incidence of lifestyle advice and treatment for uncomplicated mild hypertension in primary care: a longitudinal cohort study in the Clinical Practice Research Datalink
Published in
BMJ Open, September 2018
DOI 10.1136/bmjopen-2018-021827
Pubmed ID
Authors

James P Sheppard, Sarah Stevens, Richard J Stevens, Jonathan Mant, Una Martin, F.D. Richard Hobbs, Richard J McManus

Abstract

Evidence to support initiation of pharmacological treatment in patients with uncomplicated (low risk) mild hypertension is inconclusive. As such, clinical guidelines are contradictory and healthcare policy has changed regularly. The aim of this study was to determine the incidence of lifestyle advice and drug therapy in this population and whether secular trends were associated with policy changes. Longitudinal cohort study. Primary care practices contributing to the Clinical Practice Research Datalink in England. Data were extracted from the linked electronic health records of patients aged 18-74 years, with stage 1 hypertension (blood pressure between 140/90 and 159/99 mm Hg), no cardiovascular disease (CVD) risk factors and no treatment, from 1998 to 2015. Patients exited if follow-up records became unavailable, they progressed to stage 2 hypertension, developed a CVD risk factor or received lifestyle advice/treatment. The association between policy changes and incidence of lifestyle advice or treatment, examined using an interrupted time-series analysis. A total of 108 843 patients were defined as having uncomplicated mild hypertension (mean age 51.9±12.9 years, 60.0% female). Patientsspent a median 2.6 years (IQR 0.9-5.5) in the study, after which 12.2% (95% CI 12.0% to 12.4%) were given lifestyle advice, 29.9% (95% CI 29.7% to 30.2%) were prescribed medication and 19.4% (95% CI 19.2% to 19.6%) were given both. The introduction of the quality outcomes framework (QOF) and subsequent changes to QOF indicators were followed by significant increases in the incidence of lifestyle advice. Treatment prescriptions decreased slightly over time, but were not associated with policy changes. Despite secular trends that accord with UK guidance, many patients are still prescribed treatment for mild hypertension. Adequately powered studies are needed to determine if this is appropriate.

Twitter Demographics

The data shown below were collected from the profiles of 15 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 32%
Student > Ph. D. Student 4 18%
Student > Master 3 14%
Unspecified 2 9%
Professor > Associate Professor 2 9%
Other 4 18%
Readers by discipline Count As %
Medicine and Dentistry 11 50%
Pharmacology, Toxicology and Pharmaceutical Science 4 18%
Unspecified 3 14%
Nursing and Health Professions 1 5%
Economics, Econometrics and Finance 1 5%
Other 2 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 21. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 August 2019.
All research outputs
#818,229
of 13,807,706 outputs
Outputs from BMJ Open
#1,889
of 12,469 outputs
Outputs of similar age
#28,177
of 269,022 outputs
Outputs of similar age from BMJ Open
#72
of 541 outputs
Altmetric has tracked 13,807,706 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 12,469 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.9. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 269,022 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 541 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.