The proposed project will address this evidence-to-practice gap by evaluating the effect of practice facilitation (PF) of the intervention implementation fidelity (primary outcome) and clinical measures at 12 months (secondary outcomes).
Advancing Medication Adherence for Latinx with Hypertension through a Team-based Care Approach (ALTA) evaluates the effectiveness of using a quality improvement method called practice facilitation (PF) to implement our evidence-based systems-level intervention for improving medication adherence and blood pressure control. The ALTA intervention focuses on identifying Latinx patients with uncontrolled hypertension who are non-adherent to their antihypertensive medication, referring them to health coaches, coaching patients on medication adherence and self-management, care planning, and monitoring patients to improve patient outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
652
The study will involve each site starting with the usual care phase, followed by a period of 6 months during which practice facilitators will conduct the pre-implementation evaluation (e.g., workflow analysis, environmental scan), refine the practice facilitation strategies that will be used in the implementation phase, and train staff in the Advancing Medication Adherence for Latinos with Hypertension through a Team-based Care Approach (ALTA) intervention model. ALTA is an efficacious systems-level intervention designed to help patients improve their ability to take their high blood pressure medications and control their blood pressure. Practices and the Project ALTA team will work together to implement the ALTA model into routine care to improve blood pressure control and medication adherence in Latinx patients.
NYUMC Langone
New York, New York, United States
Implementation Fidelity - Adherence: Screening
Defined as the percentage of eligible participants who were screened.
Time frame: Up to Month 12
Implementation Fidelity - Adherence: Referrals
Defined as the percentage of screened participants who were referred.
Time frame: Up to Month 12
Implementation Fidelity - Adherence: Enrollment
Defined as the percentage of referred participants who were enrolled.
Time frame: Up to Month 12
Change in Blood Pressure (BP) Control
Assessed as the change in percentage of participants with blood pressure (BP) control, defined as systolic BP (SBP) \<140 and diastolyic BP (DBP) \<90 mmHg.
Time frame: Baseline, Post Intervention (Months 24-36)
Change in Medication Adherence
Assessed via pharmacy refills obtained from prescription orders in the clinic EHR using the proportion of days covered (PDC) metric; medication adherence defined as PDC ≥ 80; this outcome will be measured as the change in percentage of participants who meet medication adherence.
Time frame: Baseline, Post Intervention (Months 24-36)
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