The initiative has won a RCVS Knowledge Quality Improvement Award 2024
CVS Hypertension Project Enhances Identification And Treatment Of At-risk Patients
2 months ago 
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CVS’ Clinical Leadership Team has run a group-wide clinical project to increase early identification and treatment of hypertension, a common condition in cats and dogs.
The initiative has recently been named QI Winner in the RCVS Knowledge 2024 Quality Improvement Awards.
Hypertension affects 24% of cats and 10% dogs in their lifetime. Early identification can prevent long-lasting damage, such as blindness. It is recommended that cats have annual blood pressure monitoring from seven years and dogs in the last third of their lives. Senior patients, those with a predisposing disease, and those on medication that can cause secondary hypertension should receive more regular screening.
However, research suggests that regular blood pressure screening is rarely undertaken. Though relatively low-cost and readily available in veterinary practices, various barriers have been cited.
Starting in July 2022, CVS’ hypertension project looked at how effective its first opinion small animal practices were in screening older cats for hypertension. Reflecting the industry norm[i], it found less than 2% of cats over seven years were receiving an annual blood pressure check. The research also found common barriers to conducting checks were time constraints, availability of equipment, remembering and having the confidence to discuss checks with owners.
The project then nominated champions to be a central point of contact for communication and delivery at each practice. A suite of resources was produced to support the whole practice team in improving annual check rates. This included new clinical frameworks and veterinary guidelines on how to treat hypertension; in-practice educational resources[ii] to highlight the benefits of hypertension screening, and information sheets and blood pressure diaries to help clients manage their pet’s condition.
To upskill colleagues, CVS’s Knowledge Hub unique learning platform also hosted support including webinars, clinical frameworks, client resources, discussion forums and data. Three in-person CPD days promoted further learning and sharing of best practices.
Twelve months after its nationwide launch, results revealed that the number of blood pressure checks have more than doubled (110%) within participating practices, compared with 79% at non-focus sites. There was also a 22% increase in patients dispensed Amodip (a first-line antihypertensive) year-on-year, 85% of which were from focus sites.
Robert Loxley, Clinical Director at Arbury Road Vets, said: “Looking at our figures, we weren’t doing a lot of blood pressure measurements, so it was a great opportunity to give better clinical care. There’s a huge benefit in treating hypertension. So many associated longer-term conditions can be avoided if annual blood pressure checks are routinely performed.
“Increasing screening is not a simple task. We had to allow space and time for practices to undertake training, to implement systems, and to discuss checks with clients. We’ve since identified a lot of patients that do have normal blood pressures, but also cases that have received early intervention for treatment as a result of our screening.”
CVS Group operates across small animal, farm animal, equine, laboratories and crematoria, with 500 veterinary practices and referral centres in the UK and Australia. In the last five years the company has invested nearly £80 million in its sites, facilities and equipment, in addition to industry leading training and support, to give the best possible care to animals.
[i] Dhaliwal, R.; Boynton, E.; Carrera-Justiz, S.; Cruise, N.; Gardner, M.; Huntingford, J.; Lobprise, H. and Rozanski, E. (2023) ‘2023 AAHA Senior Care Guidelines for Dogs and Cats.’ Journal of American Animal Hospital Association. [online] 59, pp. 1-21. DOI: 10.5326/JAAHA-MS-7343 [Accessed 17th March 2023].
[i][i] Quimby, J.; Gowland, S.; Carney, H. DePorter, T.; Plummer, P. and Westropp, J. (2021) ‘2021 AAHA/AAFP Feline Life Stage Guidelines.’ Journal of Feline Medicine and Surgery. [online] 23, pp. 211-233. DOI: 10.1177/1098612X21993657 [Accessed 17th March 2023].
Ray, M.; Carney, H.; Boynton, B.; Quimby, J.; Robertson, S.; St Denis, K.; Tuzio, H. and Wright, B. (2021) ’2021 AAFP Feline Senior Care Guidelines.’ Journal of Feline Medicine and Surgery. [online] 23, pp. 613-638. DOI: 10.1177/1098612X211021538 [Accessed 17th March 2023].
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