UCSF BP Activate Letter Study

University of California San Francisco (UCSF)

Status: Completed

Conditions: Hypertension

Treatments: Other: Control Letter; Other: BP Activate Letter

Study type: Interventional

Funder types: Other

Identifiers

NCT06152094

22-37619

Details and patient eligibility

About

The BP Activate Study aims to assess the effectiveness of the BP Report letter with personalized BP medication recommendations, compared with Control letters and no intervention, at shortening time to appointment, time to visit, time to medication change, and time to achievement of BP goal.

Full description

The BP Activate Study is a randomized quality improvement trial. We will deliver one of two versions of a letter to established English-speaking primary care patients at Mt Zion with uncontrolled hypertension, defined by SBP>140 or DBP>90 in the past two years (identified via EHR). The letter will prompt patients to schedule a visit with their provider or team nurse practitioner to discuss their BP recommendations with their clinician. We will test 2 versions of the letter and a usual care control:

1. The "BP Activate Report Letter" group will get a letter that presents recommendations for medication changes from a computerized algorithm using the patient's medical records and recommends discussing these specific recommendations with their clinician; or
2. The "Control Letter" group will get a letter that suggests they talk to their clinician about their BP without providing any specific medication recommendations.
3. The "Usual Care" group will not receive any intervention.

This primary goal of the study is to assess the effectiveness of the BP Activate Report Letter compared with the Control Letter, and see if it shortens time to appointment, time to visit, time to medication change (primary outcome), and time to achievement of BP goal. Clinicians, with patient input, will still have full control of how BP is clinically managed. A small number of patients will be contacted by a research coordinator to hear what they thought when they received the letter, and why they did or did not act upon the information.

Enrollment: 484 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient is a primary care patient of a clinician in a general internal medicine clinic who has agreed to have their patients participate in the study
• Lowest SBP>140 or lowest DBP>90 at last visit in general internal medicine clinic
• Last visit in general internal medicine clinic was < 2 years ago
• EngageRx algorithm determines that a medication intensification step is indicated

Exclusion criteria

• Primary language is not English
• Patient's provider indicates (through an active opt-out process) that they do not want the patient to receive a BP Activate letter

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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484 participants in 3 patient groups

BP Activate Letter

Experimental group

Description:

Participants in the BP Activate Letter arm will receive a BP Report letter that includes computerized algorithm recommendations for medication changes they should discuss with their clinician.

Treatment:

Other: BP Activate Letter

Control Letter

Active Comparator group

Description:

Participants in the Control Letter arm will receive a Control letter suggesting they talk to their clinician about their blood pressure (without BP history or specific medication recommendations).

Treatment:

Other: Control Letter

Usual Care

No Intervention group

Description:

Participants in the Usual Care arm will not receive any letter or any other intervention.