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NICE to pilot ambulatory blood pressure monitoring QOF indicator

GPs could be paid an incentive to use ambulatory blood pressure readings to confirm all new diagnoses of hypertension, under NICE proposals for a new QOF indicator set out yesterday.

The NICE Primary Care Quality and Outcomes Framework Indicator Advisory Committee recommended that an indicator be piloted to ensure practices use ABPM for all new diagnoses of hypertension.

The move comes after concerns that the cost of ambulatory blood pressure monitors was preventing practices from implementing new NICE guidance published last year.

The guideline recommended anyone with a clinic blood pressure of equal to or higher than 140/90 mmHg have their diagnosis confirmed by ABPM, after evidence showed it would lead to more accurate diagnosis of hypertension.

The pilots will look into the practical issues of implementation. The committee heard concerns over costs - each ABPM machine costs £1,000 and two per practice are needed - as well as worries over infection control and whether patients might not return the machines.

The proposed wording of the indicator is: ‘The percentage of patients with a new diagnosis of hypertension after 1 April 2012 whose diagnosis was confirmed following ABPM.'

NICE committee chair Dr Colin Hunter said: ‘This is exactly the type of thing the QOF should be doing.'