VA-HTN LIFESTYLE EDUCATION (152)    REMINDER DEFINITION (811.9)

• EDIT DATE:   2012-03-23 12:52:58
  EDIT BY:   USER,SEVENTEEN
  EDIT COMMENTS:   

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Patients with a diagnosis of HTN should be counseled at least yearly on 
The reminder term for VA0HTN EXERCISE contains the education topic for 
exercise education.
 
The reminder term for VA-HTN NUTRITION contains the education topics for 
nutrition education.
 
Both of these reminder terms are required to resolve the reminder. If a 
site has an education topic that incorporates both of these educational 
interventions (nutrition and exercise) then that education topic should 
be mapped to both of these reminder terms.
the life style modifications that may improve blood pressure control.  
 
The reminder term VA-HTN NO EDUC INTERVENTION WARRANTED contains a health 
factor of the same name.  Based on the patient's comorbid illnesses and 
life expectancy, this educational intervention may not be appropriate.  
This health factor renders the reminder not applicable for 6 months.  
 
The reminder term VA-HTN INCORRECT DIAGNOSIS contains a health factor of
the same name.  The reminder becomes not applicable if the health factor
of INCORRECT HTN DIAGNOSIS is entered based on the MRD function that is
included in the custom cohort logic.  The reminder is reactivated the 
 
next time that an ICD code for HTN is entered.  
This reminder will display for a given patient if they have a diagnosis 
of HTN in the past 18 months and if their last BP is less than 140/90.  
The reminder will not display if the last DBP was >90 or if the last SBP 
was >140 because one of the other 2 HTN reminders will be due and the 
educational intervention can be addressed using that reminder.  
 

• FINDING ITEM:   VA-HTN EXERCISE EDUCATION
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  USE IN RESOLUTION LOGIC:   AND
• FINDING ITEM:   BLOOD PRESSURE
  CONDITION:   I (V("SYSTOLIC")>139)!(V("DIASTOLIC")>89)
  INTERNAL CONDITION:   I ($G(V("SYSTOLIC"))>139)!($G(V("DIASTOLIC"))>89)
  V SUBSCRIPT LIST:   "SYSTOLIC";"DIASTOLIC";
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  USE IN PATIENT COHORT LOGIC:   AND NOT
• FINDING ITEM:   VA-HTN NO EDUC INTERVENTION WARRANTED
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  USE IN PATIENT COHORT LOGIC:   AND NOT
  BEGINNING DATE/TIME:   T-6M
• FINDING ITEM:   BLOOD PRESSURE
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• FINDING ITEM:   VA-HYPERTENSION CODES
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN PATIENT COHORT LOGIC:   AND
  BEGINNING DATE/TIME:   T-18M
• FINDING ITEM:   VA-BMI
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  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-HTN NUTRITION EDUCATION
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN RESOLUTION LOGIC:   AND
• FINDING ITEM:   VA-HTN INCORRECT DIAGNOSIS
  NO. OF FOUND TEXT LINES:   0
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• LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(2)>MRD(9)
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  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

To modify this reminder from its distributed definition, copy the 
reminder to a new reminder and then make the modifications necessary to 
define your sites guideline.  
 
This reminder has customized cohort logic that uses the MRD function to 
use the INCORRECT DIAGNOSIS heath factor or the ICD code - whichever is 
entered most recently.

• URL:   http://www.oqp.domain.ext/cpg/HTN/HTN_cpg/AnnKframe.htm
  WEB SITE TITLE:   VA HTN Guideline Diet and Lifestyle Counseling
• URL:   http://www.oqp.domain.ext/cpg/HTN/HTN_base.htm
  WEB SITE TITLE:   VA HTN Guideline Web Page
• URL:   http://www.oqp.domain.ext/cpg/HTN/HTN_cpg/algo1frame.htm
  WEB SITE TITLE:   VA HTN Guideline Algorithm
• URL:   http://www.oqp.domain.ext/cpg/HTN/G/HTN_pock.pdf
  WEB SITE TITLE:   VA HTN Guideline Pocket Card

Patients with HTN should receive counseling on the following lifestyle
100-proof whiskey) per day for men or 0.5 ounces of alcohol per day for
women and for lighter weight men.
 
3.      SODIUM INTAKE:  Sodium intake in the patient with HTN should be
limited to no more than 100 mmol/day (2.4 g of sodium or 6 g of sodium
chloride).
 
4.      EXERCISE:  The target for aerobic exercise should be 30 to 45
minutes per session, three to five times per week if possible.
 
modifications:
5.      DIET:  An adequate dietary intake of potassium, calcium, and
magnesium can be obtained from fresh fruits and vegetables. Other dietary
advice should include a heart-healthy diet such as the DASH Diet. This is
one means of satisfying the dietary steps above. See the DASH Diet table
below.
 
6.      TOBACCO USE CESSATION:  Counsel to stop tobacco use and offer
smoking cessation classes or other aids to quit. (See VA/DoD Guideline on
Tobacco Use Cessation).
 
 
7.      HYPERLIPIDEMIA:  Counsel to reduce intake of dietary saturated
fats and cholesterol. A diet rich in fresh fruits and vegetables as well
as low in dietary saturated fats and cholesterol is also beneficial in
lowering blood pressure.
1.      WEIGHT REDUCTION:  Overweight patients should reduce their weight
to within 10 percent of their ideal body weight. However, reduction even
of 5 to 10 pounds can be helpful in controlling HTN.
 
2.      ALCOHOL INTAKE:  Alcohol intake should be limited to no more than
one ounce (24 ounces of beer; or 10 ounces of wine; or 2 ounces of

• REMINDER FREQUENCY:   1Y
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  NO. OF AGE NO MATCH LINES:   0