Hypertension
Conditions
Keywords
hypertension, intervention
Brief summary
The goal of this project is to improve hypertension control at Kaiser Permanente Colorado (KPCO) by implementing a population-based multi-factorial intervention that uses home BP monitors that can download BP readings to KPCO's health records via internet, interactive voice response (IVR) technology, and multidisciplinary care team. Participants will be randomized to either the home blood pressure monitoring group receiving the multi-factorial intervention or the usual care group who will be receiving Kaiser standard of care. We will determine the proportion of patients in each group who achieve their target BP goals at 6 months, according to national clinical practice guidelines. The study hypothesis is that a higher proportion of patients with uncontrolled hypertension in the home blood pressure monitoring (HBPM) group will achieve their target blood pressure compared to those in the usual care (UC) group.
Detailed description
STUDY OBJECTIVES: Primary: • To determine the proportion of patients in each group who achieve their target BP goals at 6 months, according to national clinical practice guidelines Secondary: The following parameters will be evaluated between groups: * Change in BP measures between baseline and at 6 months * Proportion of patients who are receiving antihypertensive treatments in accordance to national clinical practice guidelines * Adherence to hypertensive medication regimen during the 6-month follow-up period * Patient satisfaction with the care model.
Interventions
BEHAVIORALHome Blood Pressure Monitoring
Home blood pressure readings are taken at least 3 times a week, uploaded to a Microsoft Health Vault account through American Heart Association Heart360 at least 1 time per week. Patients are followed by a clinical pharmacist, with physician oversight, who will make adjustments to antihypertensive medications or suggest additional medications using national JNC VII and KPCO hypertension guidelines.
Sponsors
American Heart Association
Kaiser Permanente
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Age 18 to 85 years At least 1 diagnosis for hypertension, * Receive primary care from one of the participating clinics, * The two most recent BPs documented within that last 24 months are elevated (SBP\>140 and/or DBP\>90) * Receiving \< 3 antihypertensive medications, and * Have access to a computer with a USB port.
Exclusion criteria
* Pregnant, or breast-feeding, * Patients on dialysis or being followed by nephrology, * Patients with coronary artery disease, given these patients are already followed by the Clinical Pharmacy Cardiac Risk Service (CPCRS), * On KPCO Do Not Call or deceased list, * PCP does not give permission to include patient in the study, * BP is at or below target at the baseline study visit, * Not English-speaking.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| BP at 6 months | 6 months |
Countries
United States
Outcome results
None listed