Reducing Clinical Inertia in Hypertension Treatment: A Pragmatic Trial

University of Colorado Denver (CU Denver)

Status: Completed

Conditions: Hypertension

Treatments: Other: Active Outreach to Patients and Providers

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT01145391

09-0646

Details and patient eligibility

About

The goal of this project is to use health information technology and team-based care in novel ways to support the establishment of a Patient-Centered Medical Home model of care aimed at improving the diagnosis and management of hypertension. Compared with patients who receive usual care, patients who receive intervention will have a lower average systolic blood pressure 9 months after randomization.

Enrollment: 591 patients

Sex: All

Ages: 18 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult men and women age 18-79
• At least 2 Blood Pressure readings from separate days on record
• Average of last 3 Blood Pressure readings (or last 2 if only 2 available) with (Systolic Blood Pressure ≥140 or Diastolic Blood Pressure ≥90) and (last Systolic Blood Pressure ≥135 or last Diastolic Blood Pressure ≥85), recorded by any University of Colorado Hospital clinic within the last 18 months
• No clinic visit in the past month
• At least one Primary Care Physician visit in the past 18 months
• First Primary Care Physician visit at least 6 months in the past

Exclusion criteria

• Serious comorbidities, including active cancer diagnosis, hospice care, nursing home residence
• Diagnosis of diabetes (these patients are enrolled in a separate study that also targets Blood Pressure control)
• End-stage renal disease / hemodialysis
• Primary Care Physician appointment pending
• Patient instructed to monitor Blood Pressure at home / documentation of white coat hypertension
• Blood Pressure managed by specialist or outside provider

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

591 participants in 2 patient groups

Control

No Intervention group

Description:

Patients receive usual care.

Intervention

Active Comparator group

Description:

An outreach coordinator raised patient and provider awareness of unmet Blood Pressure goals, arranged Blood Pressure-focused clinic visits, and furnished providers with treatment decision support.

Treatment:

Other: Active Outreach to Patients and Providers