Blood Pressure (BP) Visit Intensification Study

Study Overview
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Brief Summary
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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.

Detailed Description
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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).

Official Title
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A Multimodal Quality Improvement Intervention Using the JNC Guidelines to Promote Control of Patients' BP in Federally Qualified Health Centers

Conditions
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Blood Pressure, Hypertension

Intervention / Treatment
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* Behavioral: JNC guideline training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Federally Qualified Health Center in the Clinic Directors Network, Practice Champion, Electronic Medical Record System Exclusion Criteria: Clinicians who have been at the practice less than 6 months, Practices planning to change Electronic Medical Record systems within the next 6 months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: JNC guideline training<br>Providers will receive current JNC guideline training for treating patients with uncontrolled hypertension. | Behavioral: JNC guideline training<br>* Providers will receive a series of trainings on what the JNC guidelines for treating uncontrolled hypertensives are and strategies for meeting those guidelines.<br>|
| No Intervention: Control<br>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. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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 |