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Factors underlying failure to intensify therapy in response to elevated blood pressure have not been systematically studied.

To examine the process of care for diabetic patients with elevated triage blood pressure (≥140/90 mm Hg) during routine primary care visits to assess whether a treatment change occurred and to what degree specific patient and provider factors correlated with the likelihood of treatment change.

Prospective cohort study.

9 Veterans Affairs facilities in 3 midwestern states.

1169 diabetic patients with scheduled visits to 92 primary care providers from February 2005 to March 2006.

Proportion of patients who had a change in a blood pressure treatment …