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| ID | Type | Description | Link |
|---|---|---|---|
| 2P30AG064199 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute on Aging (NIA) | NIH |
| Wake Forest University Health Sciences | OTHER |
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The proposed study is an effectiveness-implementation hybrid type II trial designed to evaluate the impact of provider- and patient-directed interventions on FDC use. The trial will test the effectiveness of theory-driven nudges tailored to address provider and patient barriers. All interventions will be pharmacist-driven, with pharmacists delivering information via nudges to providers and via nudges or more intensive interventions (i.e., CPA) to patients. Data to evaluate outcomes will be extracted from electronic health records.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Provider nudge only | Active Comparator | Pharmacists will deliver targeted nudges to providers through clinical decision support integrated into the EHR. |
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| Provider nudge + Patient nudge | Experimental | In addition to provider nudges (Provider nudge only arm), patients will receive pharmacist delivered nudges (e.g., text messages) 1-7 days before the visit to encourage fixed dose combination medications. |
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| Provider nudge + Pharmacist Virtual Visit | Experimental | In addition to provider nudges (Provider nudge only arm), patients will receive pharmacist counseling and prescribing delivered via virtual encounters after the visit. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Provider nudge | Behavioral | Pharmacists will deliver targeted nudges to providers through clinical decision support integrated into the electronic health record (EHR) |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in systolic blood pressure | Data for this outcome will be extracted from electronic health records. The primary effectiveness outcome will be a change in ambulatory systolic blood pressure at 3 months. For patients who do not return within 3 months, their index visit reading will be carried forward. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in diastolic blood pressure | Change in diastolic blood pressure from qualifying visit blood pressure reading to the end of the 6-month follow-up, using EHR data | 6 months |
| Percentage of patients with well-controlled blood pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Julie Lauffenburger, PharmD, PhD | Contact | 617-525-8865 | jlauffenburger@bwh.harvard.edu | |
| Rasha Khatib, PhD, MHS | Contact | rasha.alkhatib@aah.org |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| Patient nudge | Behavioral | Patients will receive pharmacist-delivered nudges (e.g., text messages) 1-7 days before their visit to encourage fixed-dosed combinations |
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| Pharmacist Virtual Visit | Behavioral | Patients will receive pharmacist counseling and prescribing delivered via virtual encounters after their visit |
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Percentage of patients who reach blood pressure control defined as <140/90mmHg
| 6 months |
| PCP level adoption: FDC prescribing; FDC discussion in EHR notes | Percentage of patients whose PCPs prescribe FDC within 6 months; any intensification at 6 months will also be explored; any FDC documentation in the notes | 6 months |
| Patient level adoption: FDC adherence (fill) | Percentage of patients who fill their first FDC prescription within 6 months; filling any intensified prescription within 6 months will also be explored. | 6 months |