What is PHASE on a Page?
PHASE on a Page is Kaiser Permanente’s evidence-based medication protocol for hypertension and diabetes management. By applying this evidence-based treatment to populations most at risk, the PHASE program has been successful in reducing cardiovascular disease morbidity by more than 60 percent among KP members since 2002.
Last Updated April 2019
Download PHASE on a Page Version 30
In version 25 of PHASE on a Page, the main change was the inclusion of Automated Office Blood Pressure (AOBP) measurement, a technique being used more frequently in outpatient settings. With AOBP, three readings are taken:
- After the cuff is placed and the button is pushed, there is a 5-minute initial rest period before the first reading.
- The second and third readings then follow at 1-minute intervals.
- An average of the three readings is used to decide whether or not the patient is at goal blood pressure.
If AOBP is available, it is preferable to conventional measurement as it has a number of advantages:
- AOBP correlates very closely to awake-home BP readings, which correlate best with prognosis.
- AOBP largely eliminates the “white coat effect,” reducing the risk of over-treatment.
IMPORTANT NOTE: The AOBP average will be lower than conventional readings. Accordingly, target BPs should be adjusted down by 5 mm Hg when AOBP is used. For example, if goal BP using conventional measurement is less than 140/90, goal using AOBP average would be less than 135/85.
The machine used is a standard blood pressure measuring device with software that times the readings. AOBP was used in the two most important recent HTN trials, ACCORD and SPRINT.
As a part of Preventing Heart Attacks and Strokes Everyday (PHASE) in the community, our organizations are working to prevent heart attacks and strokes in high-risk patient populations, using a combination of Kaiser Permanente’s clinical expertise and improved population health management capabilities. Hear from Dr. Joe Young about the program’s strategic goals and population health capacity-building focus: