Coordinated primary care improves blood pressure control in hypertension in Poland

Background

Real-world evidence on coordinated primary care for hypertension from Central and Eastern Europe remains limited. Most published evidence on structured chronic disease pathways comes from Western health systems, whereas data from routine primary care practice in Poland are still scarce. This is highly relevant because hypertension remains one of the leading modifiable cardiovascular risk factors, and primary care is the main setting for its long-term management. We assessed whether the Polish POZ PLUS model was associated with better blood pressure control than usual primary care.

Methods

We conducted a retrospective case-control study using routine electronic health records from one primary care provider in Gdansk, Poland. Adults aged 40–75 years with ICD-10 I10 were included. The coordinated care group comprised 1,308 patients enrolled between 2018 and 2022; 623 controls received standard care. First and last recorded visits were compared. Statistical analyses were performed in R (version 4.2.3) using appropriate parametric or non-parametric tests and Fisher’s exact test for categorical variables.

Results

Blood pressure control improved in both groups, but the improvement was greater under coordinated care. The proportion of patients with blood pressure in the normal range increased from 30.4% to 54.5% in the coordinated care group and from 25.3% to 37.2% in controls (both within-group p < 0.0001; between-group p < 0.0001). At the last visit, the coordinated care group also had lower median home blood pressure (130/80 vs 135/82.5 mmHg; both p < 0.0001) and lower blood pressure in the clinic (138/81 vs 145/86 mmHg; both p < 0.0001).

Conclusions

In this real-world cohort, coordinated care was associated with substantially better blood pressure control than usual care. Structured hypertension management in primary care may improve chronic disease outcomes at population level.

Key messages

• Coordinated primary care was associated with better blood pressure control than usual care.

• Structured hypertension pathways in primary care may improve real-world chronic disease management.