Journal article
Team-based home blood pressure monitoring for blood pressure equity a protocol for a stepped wedge cluster randomized trial
Contemporary clinical trials, Vol.134, 107332
11/2023
DOI: 10.1016/j.cct.2023.107332
PMCID: PMC10725081
PMID: 37722482
Abstract
Home Blood Pressure Monitoring (HBPM) that includes a team with a clinical pharmacist is an evidence-based intervention that improves blood pressure (BP). Yet, strategies for promoting its adoption in primary care are lacking. We developed potentially feasible and sustainable implementation strategies to improve hypertension control and BP equity.
We assessed barriers and facilitators to HBPM and iteratively adapted implementation strategies through key informative interviews and guidance from a multistakeholder stakeholder team involving investigators, clinicians, and practice administration.
Strategies include: 1) pro-active outreach to patients; 2) provision of BP devices; 3) deployment of automated bidirectional texting to support patients through education messages for patients to transmit their readings to the clinical team; 3) a hypertension visit note template; 4) monthly audit and feedback reports on progress to the team; and 5) training to the patients and teams. We will use a stepped wedge randomized trial to assess RE-AIM outcomes. These are defined as follows Reach: the proportion of eligible patients who agree to participate in the BP texting; Effectiveness: the proportion of eligible patients with their last BP reading <140/90 (six months); Adoption: the proportion of patients invited to the BP texting; Implementation: patients who text their BP reading ≥10 of days per month; and Maintenance: sustained BP control post-intervention (twelve months). We will also examine RE-AIM metrics stratified by race and ethnicity.
Findings will inform the impact of strategies for the adoption of team-based HPBM and the impact of the intervention on hypertension control and equity.
Registration details: www.ClinicalTrials.gov Identifier: NCT05488795.
Details
- Title: Subtitle
- Team-based home blood pressure monitoring for blood pressure equity a protocol for a stepped wedge cluster randomized trial
- Creators
- Kevin A. Fiscella - University of Rochester Medical CenterEmma Sass - University of Rochester Medical CenterSoumya B. Sridhar - University of Rochester Medical CenterJennifer A. Maguire - University of Rochester Medical CenterKatie Lashway - University of Rochester Medical CenterGeoff Wong - University of OxfordAmy Thien - University of Rochester Medical CenterMarie Thomas - University of Rochester Medical CenterJohn D. Bisognano - University of MichiganTziporah Rosenberg - University of Rochester Medical CenterMechelle R. Sanders - University of Rochester Medical CenterBrent A. Johnson - University of Rochester Medical CenterLinnea A. Polgreen - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Contemporary clinical trials, Vol.134, 107332
- DOI
- 10.1016/j.cct.2023.107332
- PMID
- 37722482
- PMCID
- PMC10725081
- NLM abbreviation
- Contemp Clin Trials
- ISSN
- 1551-7144
- eISSN
- 1559-2030
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100008091, name: University of Rochester; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: 1R33HL157643-02; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1 TR002001
- Language
- English
- Electronic publication date
- 09/16/2023
- Date published
- 11/2023
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984466746502771
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