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Table 4 Multivariable analysis of factors associated with “Appropriate Clinical Action” in response to poorly controlled hypertension, dyslipidemia, and diabetes mellitus at 12 months

From: Clinically relevant quality measures for risk factor control in primary care: a retrospective cohort study

  Poorly controlled hypertension (n = 391) Poorly controlled dyslipidemia (n = 231) Poorly controlled diabetes Mellitus (n = 59)
  Proportion OR 95% CI Proportion OR 95% CI Proportion OR 95%CI
  (%)    (%)    (%)   
Age          
<65 years 59.0    35.8    98.2   
≥65 years 66.6 1.38 (0.86-2.22) 31.9 0.84 (0.41-1.71) 97.9 0.86 (0.14-5.23)
Sex          
Female 64.5    40.5    98.5   
Male 61.8 0.89 (0.56-1.43) 29.7 0.62 (0.29-1.30) 97.6 0.60 (0.09-3.99)
Co-occurrence of other conditions          
no co-occurrence of HT, DL, DM 62.0    42.0    NA   
HT and DL 67.1 1.25 (0.64-2.41) 30.8 0.62 (0.19-1.98)    
HT and DM 62.8 1.03 (0.35-3.06)     76.3 ref  
DL and DM     9.4 0.14 (0.01-1.43) 100.0 NA  
All 3 conditions 58.7 0.87 (0.41-1.86) 43.6 1.07 (0.23-5.00) 90.1 2.81 (0.27-29.11)
Number of other conditions          
increase 1 co-morbidity   1.23 (0.93-1.63)   0.92 (0.57-1.49)   0.63 (0.19-2.09)
Risk status          
No target organ disease 61.4    17.9    NA   
Target organ disease (except CAD) 65.4 1.19 (0.56-2.52) 49.0 4.41 (1.59-12.19)** 97.6 ref  
CAD 56.0 0.80 (0.31-2.07) 51.0 4.78 (1.27-18.02)* 99.3 3.27 (0.12-87.75)
Baseline level of each condition          
Systolic BP          
140-159 mmHg 59.9         
160-179 mmHg 62.6 1.12 (0.67-1.88)       
≥180 mmHg 93.0 8.86 (1.06-73.98)*       
Diastolic BP          
90-99 mmHg 59.9         
100-109 mmHg 73.7 1.88 (0.87-4.08)       
≥110 mmHg 91.0 6.78 (0.71-65.14)       
LDL cholesterol level          
3.4-4.1 mmol/L (130–159 mg/dL)     22.5      
4.2-4.9 mmol/L (160–189 mg/dL)     44.6 2.77 (1.15-6.68)*    
≥5.0 mmol/L (≥190 mg/dL)     54.2 4.08 (1.32-12.62)*    
Haemoglobin A1c          
8.0-8.9%        98.1   
9.0-9.9%        99.0 2.75 (0.12-31.21)
≥10.0%        96.0 0.45 (0.07-3.07)
  1. Hierarchical logistic regression with adjustment for all the covariates in the table. Patient factors associated with “appropriate clinical action” vs. “inappropriate clinical action” at 12 months were assessed in these multivariable models. “Appropriate clinical action” was defined as therapy modifications or return to control without therapy modification. BP = blood pressure; CAD = coronary artery disease; LDL = low-density lipoprotein; HT = hypertension; DL = dyslipidemia; DM = diabetes mellitus. OR = odds ratio; 95% CI = 95% confidence interval; NA = not available. Odds Ratios are related to the first class shown for each category. Due to low number of patients with poorly controlled diabetes mellitus some calculations for proportions, odds ratios and 95% confidence interval are not feasible. Ref = reference category in diabetes mellitus due to low number of patients. *P < 0.05 compared to reference group; **P < 0.01 compared to reference group.
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