Hypertension
Conditions
Keywords
blood pressure, remote monitoring
Brief summary
A 3-arm randomized pilot trial aimed at comparing the effectiveness of different approaches to recruiting patients to participate in a 6-month remote monitoring program for the management of hypertension (HTN).
Detailed description
The investigators will utilize the Way to Health (WTH) platform to develop and evaluate a new remote monitoring enrollment model that is integrated with routine clinical care at Penn Family Care (PFC), an academic family medicine practice in West Philadelphia. Among patients with poorly controlled HTN the investigators will: 1. Compare the effect of sending eligible patients a blood pressure cuff with the mailed invitation letter and opt-out framing versus the more conventional method of phone calls following mailed letters. 2. Evaluate the feasibility and effectiveness of a remote monitoring program with individualized stepped escalation for hypertension management.
Interventions
BEHAVIORALOpt-In Recruitment
Patients in the opt-in recruitment arm will receive a letter describing the program and inviting them to participate in the remote monitoring program. Along with the letter they will receive an informational brochure and a copy of the informed consent form. Patients in this arm will then receive a recruitment phone call explaining the program and consenting the participant verbally. If the participant consents to participate in the remote monitoring program, to receive text messaging, and to connection to care, the research coordinator will mail a blood pressure cuff and begin the remote monitoring program for the patient 6 days later.
BEHAVIORALOpt-Out Recruitment
Patients assigned to opt-out recruitment will receive a blood pressure cuff with instructions in the mail along with a letter describing the program and opt-out framing regarding their participation, as well as a brochure and a copy of the informed consent form. Patients in this arm will receive a recruitment phone call similar to recruitment arm A, explaining the program and consenting the participant verbally. If the participant consents to participate in the remote monitoring program, to receive text messaging, and to connection to care, the research coordinator will begin the remote monitoring program for the patient immediately.
Sponsors
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Between 18 and 75 years old with HTN (ICD-10 code I10) 2. Has had at least one office visit at Penn Family Care (PFC) within the past 12 months (at time of chart review), with the last visit having a BP reading exceeding HTN guidelines (150/90 if \>60 or, 140/90 if ages 21-59 yrs or has CKD or diabetes). 3. Must have a cellular phone with texting capabilities 4. Must be prescribed at least one medication for hypertension
Exclusion criteria
1. Has metastatic (Stage IV) cancer 2. Has end stage renal disease 3. Has congestive heart failure 4. Has dementia 5. BMI \>= 50 6. Is Non-English speaking requiring a translator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion Participating by Recruitment Method | 6 months, from date of consent to end of remote monitoring program | The proportion of patients participating in each study arm out of the number randomized to that study arm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion Engaged by Recruitment Method | 6 months, from date of consent to end of remote monitoring period | The proportion of patients recruited by each method who are actively engaged with the program |
| Proportion with Controlled Blood Pressure by Monitoring vs. Usual Care | 6 months, from date of consent to end of remote monitoring program | The proportion with controlled blood pressure by remote monitoring and the proportion with controlled blood pressure by clinic visits (usual care). |
| Blood Pressure Trajectory by Recruitment Method | 6 months, from date of consent to end of remote monitoring program | The systolic and diastolic blood pressure trajectory by recruitment arm. |
| Proportion of BP Measurements Submitted by Recruitment Method | 6 months, from date of consent to end of remote monitoring program | The proportion of requested BP measurements submitted by each patient by recruitment arm |
Countries
United States
Outcome results
None listed