This study is a prospective cluster randomized trial testing a systems-level strategy to implement current American Heart Association hypertension guidelines in African American communities at risk for cardiovascular related health disparities. The trial will take place within an integrated health system serving Detroit and will assess blood pressure control over one year's time.
The trial will randomize 12 clinics within the Henry Ford Health System to two arms. The first arm will be comparison clinics that continue to use existing team-based strategies for hypertension management. The second arm will be intervention clinics. These clinics will have enhancements to existing team-based hypertension management. The first enhancement is clinical decision support based in the electronic health record. The second enhancement is improved protocols to implement telehealth prescribing that is nurse-led. The trial will enroll participants through an urban emergency department. Participants will be assigned to one of these 12 clinics and continue study activities for 1 year. Clinicians at the clinics will manage blood pressure. Study specific visits will occur at 3, 6, 9, and 12 months. Primary outcome assessment is 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enhancements to team-based care include clinical decision support and improved protocols for telehealth prescribing.
Usual, team-based care
Henry Ford Hospital
Detroit, Michigan, United States
Change in systolic blood pressure
mean change
Time frame: 12 months
Therapeutic Intensity
Calculated therapeutic intensity score
Time frame: 12 months
Change in systolic blood pressure
mean change
Time frame: 6 months
Change in diastolic blood pressure
mean change
Time frame: 12 months
Treatment Congruence
Proportion of clinical encounters in which treatment is congruent with guidelines
Time frame: 12 months
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