This is a pilot study of a method to compare common, FDA-approved drugs in a clinic. Instead of putting single patients into one of two drug groups, the investigators will assign the doctors who prescribe these drugs for high blood pressure into two groups. One group of doctors has agreed to prescribe mostly ("favor") one drug, chlorthalidone, if that drug would be a good choice for a patient. The other group has agreed to prescribe mostly hydrochlorothiazide. For both groups, they will try to use the doses that were shown to be protective in other trials. If the doctors mostly prescribe the drug they agreed to favor, the investigators will be able to compare outcomes, like heart attacks, in the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
20
Providers will be randomized to either Favor Chlorthalidone or Favor Hydrochlorothiazide for patients who are to be newly prescribed a thiazide for hypertension, whether the thiazide is 1st line or add-on therapy. Providers will have agreed to adhere to their assignment for patients for whom there is equipoise, but they are free to deviate if medically indicated for individual patients. There is no requirement to maintain the initial thiazide therapy; it is expected that the regimen may require adjustment over time. The cluster assignment is simply to favor a particular thiazide on initiation of thiazide therapy and attempt to reach the target dose.
Edward Hines, Jr. VA Hospital
Hines, Illinois, United States
Charles George VAMC
Asheville, North Carolina, United States
Wilkes-Barre VA Medical Center
Wilkes-Barre, Pennsylvania, United States
WJB Dorn VA Medical Center
Columbia, South Carolina, United States
WJB Dorn VAMC/Columbia Orangeburg VA Outpatient Clinic
Orangeburg, South Carolina, United States
Prescription Rates
rates of provider prescribing of the Cluster Designated drug
Time frame: nine months
Factors Associated With Prescribing Patterns
factors (barriers and facilitators) associated with prescribing according to the Cluster Designation
Time frame: nine months
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