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Hypertension (HT)

Evengelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran

Type
Disease or Syndrome
ID
PH532
Version ID
1064
Data Sources
Valid event data range
01/01/2000 - 31/12/2007
Sex
Female, Male
Agreement Date
2012-08-22
Coding system
Read codes v2 OXMIS codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

The UK’s Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics.

Methods:

Using the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653 500 patients in which 23 920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design.

Results:

Recorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7–14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7–8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence.

Conclusions:

The introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.

Publications

  • Evangelos Kontopantelis, David Reeves, Jose M Valderas, Stephen Campbell, Tim Doran, Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme a longitudinal observational study. BMJ Qual Saf, 22, 53-64, 2013.

Clinical Code List

Rows: 98
Code Description Entity type Coding System (OXMIS Read) Category
2126100 Hypertension resolved res43: ht_kontopantelis_bmjqs2012 Read diagnostic
212K.00 Hypertension resolved res43: ht_kontopantelis_bmjqs2012 Read diagnostic
662..12 Hypertension monitoring res43: ht_kontopantelis_bmjqs2012 Read test
6627.00 Good hypertension control res43: ht_kontopantelis_bmjqs2012 Read test
6628.00 Poor hypertension control res43: ht_kontopantelis_bmjqs2012 Read test
6629.00 Hypertension:follow-up default res43: ht_kontopantelis_bmjqs2012 Read test
662F.00 Hypertension treatm. started res43: ht_kontopantelis_bmjqs2012 Read drug
662G.00 Hypertensive treatm.changed res43: ht_kontopantelis_bmjqs2012 Read drug
662O.00 On treatment for hypertension res43: ht_kontopantelis_bmjqs2012 Read drug
662P.00 Hypertension monitoring res43: ht_kontopantelis_bmjqs2012 Read test
662b.00 Moderate hypertension control res43: ht_kontopantelis_bmjqs2012 Read test
662c.00 Hypertension six month review res43: ht_kontopantelis_bmjqs2012 Read test
662d.00 Hypertension annual review res43: ht_kontopantelis_bmjqs2012 Read test
8B26.00 Antihypertensive therapy res43: ht_kontopantelis_bmjqs2012 Read drug
8BL0.00 Patient on maximal tolerated antihypertensive therapy res43: ht_kontopantelis_bmjqs2012 Read drug
8CR4.00 Hypertension clinical management plan res43: ht_kontopantelis_bmjqs2012 Read test
8HT5.00 Referral to hypertension clinic res43: ht_kontopantelis_bmjqs2012 Read test
9N03.00 Seen in hypertension clinic res43: ht_kontopantelis_bmjqs2012 Read test
9N1y200 Seen in hypertension clinic res43: ht_kontopantelis_bmjqs2012 Read test
9OI1.00 Attends hypertension monitor. res43: ht_kontopantelis_bmjqs2012 Read test
9OIA.00 Hypertension monitor.chck done res43: ht_kontopantelis_bmjqs2012 Read test
9OIA.11 Hypertension monitored res43: ht_kontopantelis_bmjqs2012 Read test
F404200 Blind hypertensive eye res43: ht_kontopantelis_bmjqs2012 Read symptom
F421300 Hypertensive retinopathy res43: ht_kontopantelis_bmjqs2012 Read symptom
G2...00 Hypertensive disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G2...11 BP - hypertensive disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G20..00 Essential hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G20..11 High blood pressure res43: ht_kontopantelis_bmjqs2012 Read symptom
G200.00 Malignant essential hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G201.00 Benign essential hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G202.00 Systolic hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G20z.00 Essential hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G20z.11 Hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G21..00 Hypertensive heart disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G210.00 Malignant hypertensive heart disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G210000 Malignant hypertensive heart disease without CCF res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G210100 Malignant hypertensive heart disease with CCF res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G210z00 Malignant hypertensive heart disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G211.00 Benign hypertensive heart disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G211000 Benign hypertensive heart disease without CCF res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G211100 Benign hypertensive heart disease with CCF res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G211z00 Benign hypertensive heart disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G21z.00 Hypertensive heart disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G21z000 Hypertensive heart disease NOS without CCF res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G21z011 Cardiomegaly - hypertensive res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G21z100 Hypertensive heart disease NOS with CCF res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G21zz00 Hypertensive heart disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G22..00 Hypertensive renal disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G220.00 Malignant hypertensive renal disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G221.00 Benign hypertensive renal disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G222.00 Hypertensive renal disease with renal failure res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G22z.00 Hypertensive renal disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G22z.11 Renal hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G23..00 Hypertensive heart and renal disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G230.00 Malignant hypertensive heart and renal disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G231.00 Benign hypertensive heart and renal disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G232.00 Hypertensive heart&renal dis wth (congestive) heart failure res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G233.00 Hypertensive heart and renal disease with renal failure res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G234.00 Hyperten heart&renal dis+both(congestv)heart and renal fail res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G23z.00 Hypertensive heart and renal disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G24..00 Secondary hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G240.00 Secondary malignant hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G240000 Secondary malignant renovascular hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G240z00 Secondary malignant hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G241.00 Secondary benign hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G241000 Secondary benign renovascular hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G241z00 Secondary benign hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G244.00 Hypertension secondary to endocrine disorders res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G24z.00 Secondary hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G24z000 Secondary renovascular hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G24zz00 Secondary hypertension NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G2y..00 Other specified hypertensive disease res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G2z..00 Hypertensive disease NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
G672.00 Hypertensive encephalopathy res43: ht_kontopantelis_bmjqs2012 Read symptom
G672.11 Hypertensive crisis res43: ht_kontopantelis_bmjqs2012 Read symptom
Gyu2000 [X]Other secondary hypertension res43: ht_kontopantelis_bmjqs2012 Read diagnostic
Gyu2100 [X]Hypertension secondary to other renal disorders res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L120.00 Benign essential hypertension in pregnancy/childbirth/puerp res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L120000 Benign essential hypertension in preg/childb/puerp unspec res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L120100 Benign essential hypertension in preg/childb/puerp - deliv res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L120300 Benign essential hypertension in preg/childb/puerp-not deliv res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L120400 Benign essential hypertension in preg/childb/puerp +p/n comp res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L120z00 Benign essential hypertension in preg/childb/puerp NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121.00 Renal hypertension in pregnancy/childbirth/puerperium res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121000 Renal hypertension in pregnancy/childbirth/puerp unspecified res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121100 Renal hypertension in pregnancy/childbirth/puerp - delivered res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121200 Renal hypertension in preg/childb/puerp -deliv with p/n comp res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121300 Renal hypertension in preg/childbirth/puerp - not delivered res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121400 Renal hypertension in preg/childb/puerp + p/n complication res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L121z00 Renal hypertension in pregnancy/childbirth/puerperium NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L122.00 Other pre-existing hypertension in preg/childbirth/puerp res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L122000 Other pre-existing hypertension in preg/childb/puerp unspec res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L122100 Other pre-existing hypertension in preg/childb/puerp - deliv res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L122300 Other pre-exist hypertension in preg/childb/puerp-not deliv res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L122400 Other pre-exist hypertension in preg/childb/puerp + p/n comp res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L122z00 Other pre-existing hypertension in preg/childb/puerp NOS res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L128.00 Pre-exist hypertension compl preg childbirth and puerperium res43: ht_kontopantelis_bmjqs2012 Read diagnostic
L128200 Pre-exist 2ndry hypertens comp preg childbth and puerperium res43: ht_kontopantelis_bmjqs2012 Read diagnostic
Rows: 67
Code Description Entity type Coding System (OXMIS Read) Category
3053HT NEUROGENIC HYPERTENSION (SECONDARY) res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4000 MALIGNANT HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4003 HYPERTENSIVE NEPHROPATHY res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4003AA HYPERTENSIVE RENAL DISEASE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 BENIGN HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 A HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 AC HYPERTENSION ACCELERATED res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 AR HYPERTENSION ARTERIOSCLEROTIC res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 AT HYPERTENSION ATHEROSCLEROTIC res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 B RETINOPATHY HYPERTENSIVE res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
401 BE RETINOPATHY HYPERTENSIVE EXUDATES res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
401 BH RETINOPATHY HYPERTENSIVE HAEMORRHAGE res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
401 BM HYPERTENSION ON TREATMENT res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 BN HYPERTENSION BENIGN res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 BP RETINOPATHY HYPERTENSIVE PAPILLOEDEMA res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
401 BR HYPERTENSION RESOLVED res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 C HYPERTENSION ESSENTIAL res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 DC HYPERTENSION DIASTOLIC res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 E HYPERTENSION ARTERIAL res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 EL HYPERTENSION ARTERIAL SYSTEMIC res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 LB HYPERTENSION LABILE INTERMITTENT res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 NC HYPERTENSION NECROTIZING STAGES res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 P HYPERTENSION ARTERIAL PRIMARY res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 PA HYPERTENSION PRIMARY res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 R HYPERTENSION CRISIS res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
401 S HYPERTENSION SYSTOLIC res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
401 T THROMBOSIS HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
402 HYPERTENSIVE HEART DISEASE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
402 C HYPERTENSION CONGESTIVE HEART FAILURE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
402 MF MYOCARDIAL FIBROSIS WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
402 VH VENTRICULAR HYPERTROPHY HYPERTENSIVE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 RENAL HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 AA RENAL HYPERTENSIVE DISEASE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 AH RENOVASCULAR HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 M NEPHROPATHY MALIGNANT HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
403 NC HYPERTENSION IMPAIRED RENAL FUNCTION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 NF HYPERTENSION RENAL INSUFFICIENCY res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 NG HYPERTENSIVE GLOMERULOSCLEROSIS res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
403 NH NEPHROSCLEROSIS HYPERTENSIVE res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
4100N MYOCARDIAL INFARCT WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4100NA MYOCARDIAL INFARCT ACUTE WITH HYPERTENSI res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4100T THROMBOSIS CORONARY WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4120 INSUFFICIENCY CORONARY HYPERTENSIVE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4120A ISCHAEMIC HEART DISEASE HYPERTENSIVE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4120BD SYNDROME DRESSLER'S WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4120CA CORONARY ARTERY DISEASE WITH HYPERTENSIO res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4120M MYOCARDIAL ISCHAEMIA WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4130 ANGINA PECTORIS WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4130E ANGINA EFFORT WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4140 ASYMPTOMATIC HYPERTENSIVE ISCHAEMIC HEAR res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4300 SUBARACHNOID HAEMORRHAGE WITH HYPERTENSI res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4310 HAEMORRHAGE INTRACEREBRAL WITH HYPERTENS res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4330 CEREBRAL THROMBOSIS WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4340 EMBOLISM CEREBRAL WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4340CR EMBOLISM INTRACRANIAL WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4360A CEREBROVASCULAR ACCIDENT WITH HYPERTENSI res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4360B STROKE WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4360D HYPERTENSIVE ENCEPHALOPATHY res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4370 CEREBRAL ISCHAEMIA HYPERTENSIVE res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4380 CEREBROVASCULAR DISEASE WITH HYPERTENSIO res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4380HP HEMIPLEGIA WITH HYPERTENSION res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
4419H HYPERTENSION ANEURYSM AORTA res43: ht_kontopantelis_bmjqs2012 OXMIS diagnostic
791 HP HYPERTENSIVE HEADACHE res43: ht_kontopantelis_bmjqs2012 OXMIS symptom
L0010AM SEEN IN HYPERTENSION CLINIC res43: ht_kontopantelis_bmjqs2012 OXMIS test
L0010EM REFERRED TO HYPERTENSION CLINIC res43: ht_kontopantelis_bmjqs2012 OXMIS test
Y060 JA HYPERTENSION CLINIC res43: ht_kontopantelis_bmjqs2012 OXMIS test
Y0601JA HYPERTENSION CLINIC ATTENDANCE res43: ht_kontopantelis_bmjqs2012 OXMIS test

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH532/version/1064/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH532/version/1064/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH532', '1064', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH532/version/1064/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH532/version/1064/export/codes/?format=json
CSV site_root/phenotypes/PH532/version/1064/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH532', '1064', api_client=client)

Version History

Version
ID
Name Owner Publish date
1064 Hypertension (HT) ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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