View Clinical Trial (Medical Research Study)
Multi-Method Health System QI Intervention to Reduce Hypertension Disparities
| City: |
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Baltimore |
| State: |
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Maryland |
| Zip Code: |
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21211 |
| Conditions: |
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Hypertension |
| Purpose: |
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The investigators have designed a three-part quality improvement intervention to 1) improve
the clinic-based measurement of blood pressure, 2) introduce a care management system to
promote self-management behaviors and rapidly titrate medications by algorithms developed in
accord with guidelines and 3) introduce an interactive, needs-based, longitudinal-provider
education system that promotes patient-centered care and provides practical examples of
patient-provider communication strategies. The intervention will occur at six clinics
within the metropolitan area of Baltimore, Maryland. The investigators will also describe
clinic and health system characteristics and measure their association with implementation
(uptake), success (improvements in blood pressure control and reductions in racial
disparities), and sustainability of the three-part intervention over 12 -24 months.
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| Study Summary: |
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Hypertension is common in the US. From efficacy and observational studies, we know that
achieving blood pressure control can reduce morbidity and mortality. However, less than
one-third of persons with hypertension achieve control as defined by national guidelines.
Furthermore, racial disparities in hypertension have been clearly documented with African
American patients being less likely than Caucasians to achieve adequate control. The
objective of this study is to study the implementation of a multi-method quality improvement
intervention in a pragmatic clinical trial. Six clinic sites within the Johns Hopkins
Community Physicians (JHCP) healthcare system have been selected for participation in this
study. The sites are located within the metropolitan ara of Baltimore, Maryland, yet differ
greatly. We will define the context and local characteristics of each study site and
determine which characteristics are associated with blood pressure control and racial
disparity at the clinic (micro-system) and health system (macro-system)level. We will
deploy a three-part quality improvement intervention to 1) improve the clinic-based
measurement of blood pressure, 2) introduce a care management system to promote patients'
self-management behaviors and rapidly titrate medications by algorithms developed in accord
with guidelines and 3) introduce an interactive, needs-based, longitudinal-provider
education system that promotes patient-centered care and provides practical examples of
patient-provider communication strategies. Using statistical process control charting, we
will determine the stability of blood pressure control in the system prior to intervention
and after the introduction of each intervention. We will vary the order of the
interventions among the six clinical sites to determine if each intervention is
independently effective in each local context and if the effect is repeatable in other
contextual situations within the same macro-system. In addition, we will study the
organizational characteristics and features of the local context that are associated with
implementation, uptake of the interventions and success of each intervention in achieving
blood pressure control and reducing racial disparities in blood pressure control at the
clinic level .
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| Criteria: |
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Inclusion Criteria:
- patients with an ICD9 diagnosis of hypertension or a BP >=120/>=80 who have not been
seen in the last 12 months and
- any patient with their most recent BP >=140/>=90 or >=130/>=80 if they have diabetes
mellitus or chronic kidney disease.
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| NCT ID: |
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NCT01566864 |
| Primary Contact: |
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Principal Investigator
Lisa A Cooper, MD, MPH
Johns Hopkins School of Medicine
Lisa A Cooper, MD, MPH
Phone: 410-614-3659
Email: lisa.cooper@jhmi.edu
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| Backup Contact: |
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Email: kdietz4@jhmi.edu
Katie Dietz, MPH
Phone: 443-287-1826
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| Location Contact: |
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Baltimore, Maryland 21211
United States
There is no listed contact information for this specific location.
Site Status: Recruiting |
| Data Source: |
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ClinicalTrials.gov |
| Date Processed: |
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June 18, 2013 |
| Modifications to this listing: |
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