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Aim 1: The purpose of the study is to implement the Seventh Joint National Committee on the Diagnosis, Prevention and Treatment of Hypertension (JNC VII) recommendation for monthly visits for hypertensive patients with uncontrolled blood pressure (BP) using a theoretically-informed, empirically grounded, multimodal quality improvement (QI) intervention.
Aim 2: To improve BP control and reduce disparity in BP through implementation of monthly visits.
Aim 3: To assess potential mediators and moderators of the intervention.
This study is a stepped wedged cluster randomized trial designed to improve management of uncontrolled blood pressure among patients in federally qualified health centers through the auspices of the the Clinical Directors Network Practice-Based Research Network (CDN PBRN).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| JNC guideline training | Experimental | Providers will receive current JNC guideline training for treating patients with uncontrolled hypertension. |
|
| Control | No Intervention | Provider patient panels will be assessed for number of uncontrolled hypertensives before receiving the JNC guidelines training. These baseline characteristics will serve as their control conditions. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| JNC guideline training | Behavioral | Providers will receive a series of trainings on what the JNC guidelines for treating uncontrolled hypertensives are and strategies for meeting those guidelines. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of office visits | Increase patient visit intensification for patients with uncontrolled blood pressure (BP) until the BP is under control. | Baseline and aniticipated at 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Reduction in Blood Pressure | Providers patient panels will be assessed to understand any changes in blood pressure from baseline | Baseline and anticipated at year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kevin A Fiscella, MD MPH | University of Rochester | Principal Investigator |
| Jonathan Tobin, PhD | Clinical Directors Network | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34379277 | Derived | Fiscella K, He H, Sanders M, Cassells A, Carroll JK, Williams SK, Cornell J, Holder T, Khalida C, Tobin JN. Blood Pressure Visit Intensification in Treatment (BP-Visit) Findings: a Pragmatic Stepped Wedge Cluster Randomized Trial. J Gen Intern Med. 2022 Jan;37(1):32-39. doi: 10.1007/s11606-021-07016-9. Epub 2021 Aug 11. | |
| 26678642 | Derived | Fiscella K, Ogedegbe G, He H, Carroll J, Cassells A, Sanders M, Khalida C, D'Orazio B, Tobin JN. Blood Pressure Visit Intensification Study in Treatment: Trial design. Am Heart J. 2015 Dec;170(6):1202-10. doi: 10.1016/j.ahj.2015.08.022. Epub 2015 Sep 12. |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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