Cognitive Decline, Hypertension
Conditions
Keywords
Hypertension, Cognitive Decline, Mild Cognitive Decline, Memory Loss, Memory Disorders, Memory Impairment, Blood Pressure, Blood Pressure, High
Brief summary
This purpose of this study is to examine an aggressive method of blood pressure control that involves home blood pressure monitoring and management of medications by a team of clinical pharmacists in coordination with a primary care physician.
Interventions
The vCCC will operate under a collaborative care agreement with the Primary Care Physicians as an extension (and not a replacement) of their care. Trained clinical pharmacists will monitor blood pressure and prescribe and adjust medications under the license of, and in communication with, the patient's Primary Care Physician. As part of the Primary Care Physician's team and per Primary Care Physician's directions, the pharmacists may coordinate blood pressure management with other clinicians such as cardiologists or nephrologists co-managing patients blood pressure.
Sponsors
National Institute on Aging (NIA)
University of Kansas Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 65 and older * Active patient in participating primary care clinic * Access to compatible smartphone or device (i.e., Android, Kindle or Apple with internet connectivity) * Elevated blood pressure as defined by: Systolic Blood Pressure \>140 at current visit AND documented history of hypertension OR Systolic Blood Pressure \> 140 at current visit and at another visit in last 18 months OR Systolic Blood Pressure \>160 at current visit * Sufficiently fluent in English to participate in study procedures * Adequate vision and hearing to complete study procedures
Exclusion criteria
* Clinically significant illness that may affect safety or completion per their treating Primary Care Physician or study physician * End stage renal disease on dialysis * Chronic active disease with expected life expectancy \< 2 years as determined by the study team
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of system wide adoptability as assessed by survey responses | Baseline | Primary Care Physicians and vCCC Pharmacists will be asked for feedback on feasibility of implementation via a survey. The vCCC pharmacists and PCPs will be surveyed to assess feasibility and changing views of feasibility. Brief, validated scales will be delivered via email (REDCap surveys) to assess the construct of feasibility. |
| Feasibility of system wide adoptability as assessed by Physician Advisory Board meetings discussion | Through study completion, an average of 9 months | Members of the Physician Advisory Board will be asked for feedback on system wide adoptability during the monthly Physician Advisory Board meetings. The meetings will be recorded and summarized. |
| Feasibility of system wide adoptability as assessed by vCCC Pharmacist Interviews | Up to 2 months Post Baseline | Virtual Collaborative Care Clinic Pharmacists will be asked for feedback on feasibility of system wide adoption. We will conduct one-time semi-structured qualitative interviews with the Virtual Collaborative Care Clinic pharmacists. The Virtual Collaborative Care Clinic pharmacist will be interviewed to assess implementation factors including the auto-referral process and open-ended questions on the process and suggestions for improvement. |
| Replicability to other health systems as assessed by survey responses | Baseline | Primary Care Physicians and vCCC Pharmacists will be asked for feedback on replicability to other health systems via a survey. Brief, validated scales will be delivered via email (REDCap surveys) to assess the construct of replicability to other health systems. |
| Replicability to other health systems as assessed by Physician Advisory Board meetings discussion | Through study completion, an average of 9 months | Members of the Physician Advisory Board will be asked for feedback on replicability to other health systems during the monthly Physician Advisory Board meetings. The meetings will be recorded and summarized. |
| Replicability to other health systems as assessed by vCCC Pharmacist Interviews | Up to 2 months Post Baseline | vCCC Pharmacists will be asked for feedback on replicability to other health systems. We will conduct one-time semi-structured qualitative interviews including open-ended questions. |
Countries
United States
Outcome results
None listed