Trial Outcomes & Findings for Southeastern Collaboration to Improve Blood Pressure Control (NCT NCT02866669)

Last Updated: 2023-10-05

Results Overview

Blood pressure (BP) control is defined as systolic pressure less than 140 mm Hg and diastolic pressure less than 90 mm Hg. Difference in BP control at 12 month follow-up between trial arms. BP was assessed in the practice by a research assistant using a standardized protocol at baseline, 6, and 12 months.

Recruitment status

COMPLETED

Study phase

Target enrollment

1592 participants

Primary outcome timeframe

12 months

Results posted on

2023-10-05

Participant Flow

We used a random number generator to randomize practices into 4 trial arms; The goal was to recruit approximately 25 participants at each of the randomized practices. The 4 trial arms were enhanced usual care, practice facilitation, peer coaching, and both practice facilitation and peer coaching. Each participant had baseline, 6 month and 12 month data collected. The intervention duration was one year.

Unit of analysis: Practices

Participant milestones

Participant milestones
Measure	Enhanced Usual Care Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Overall Study STARTED	406 18	382 16	424 19	380 16
Overall Study COMPLETED	342 16	260 12	332 17	275 15
Overall Study NOT COMPLETED	64 2	122 4	92 2	105 1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

One participant was missing information on educational attainment.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Enhanced Usual Care n=342 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=260 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=332 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=275 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Total n=1209 Participants Total of all reporting groups
Age, Continuous	59 years STANDARD_DEVIATION 12 • n=342 Participants	56 years STANDARD_DEVIATION 11 • n=260 Participants	58 years STANDARD_DEVIATION 12 • n=332 Participants	57 years STANDARD_DEVIATION 12 • n=275 Participants	58 years STANDARD_DEVIATION 12 • n=1209 Participants
Sex: Female, Male Female	206 Participants n=342 Participants	153 Participants n=260 Participants	205 Participants n=332 Participants	184 Participants n=275 Participants	748 Participants n=1209 Participants
Sex: Female, Male Male	136 Participants n=342 Participants	107 Participants n=260 Participants	127 Participants n=332 Participants	91 Participants n=275 Participants	461 Participants n=1209 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	15 Participants n=342 Participants	7 Participants n=260 Participants	16 Participants n=332 Participants	13 Participants n=275 Participants	51 Participants n=1209 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	327 Participants n=342 Participants	251 Participants n=260 Participants	316 Participants n=332 Participants	261 Participants n=275 Participants	1155 Participants n=1209 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=342 Participants	2 Participants n=260 Participants	0 Participants n=332 Participants	1 Participants n=275 Participants	3 Participants n=1209 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=342 Participants	0 Participants n=260 Participants	0 Participants n=332 Participants	0 Participants n=275 Participants	0 Participants n=1209 Participants
Race (NIH/OMB) Asian	0 Participants n=342 Participants	0 Participants n=260 Participants	0 Participants n=332 Participants	0 Participants n=275 Participants	0 Participants n=1209 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=342 Participants	0 Participants n=260 Participants	0 Participants n=332 Participants	0 Participants n=275 Participants	0 Participants n=1209 Participants
Race (NIH/OMB) Black or African American	342 Participants n=342 Participants	260 Participants n=260 Participants	332 Participants n=332 Participants	275 Participants n=275 Participants	1209 Participants n=1209 Participants
Race (NIH/OMB) White	0 Participants n=342 Participants	0 Participants n=260 Participants	0 Participants n=332 Participants	0 Participants n=275 Participants	0 Participants n=1209 Participants
Race (NIH/OMB) More than one race	0 Participants n=342 Participants	0 Participants n=260 Participants	0 Participants n=332 Participants	0 Participants n=275 Participants	0 Participants n=1209 Participants
Race (NIH/OMB) Unknown or Not Reported	0 Participants n=342 Participants	0 Participants n=260 Participants	0 Participants n=332 Participants	0 Participants n=275 Participants	0 Participants n=1209 Participants
Region of Enrollment United States · NC	182 Participants n=342 Participants	158 Participants n=260 Participants	134 Participants n=332 Participants	145 Participants n=275 Participants	619 Participants n=1209 Participants
Region of Enrollment United States · AL	160 Participants n=342 Participants	102 Participants n=260 Participants	198 Participants n=332 Participants	130 Participants n=275 Participants	590 Participants n=1209 Participants
Baseline systolic BP, mm Hg	158 mm Hg STANDARD_DEVIATION 18 • n=342 Participants	156 mm Hg STANDARD_DEVIATION 17 • n=260 Participants	153 mm Hg STANDARD_DEVIATION 14 • n=332 Participants	157 mm Hg STANDARD_DEVIATION 17 • n=275 Participants	156 mm Hg STANDARD_DEVIATION 16 • n=1209 Participants
Educational Attainment less than high school	81 Participants n=342 Participants • One participant was missing information on educational attainment.	63 Participants n=260 Participants • One participant was missing information on educational attainment.	64 Participants n=331 Participants • One participant was missing information on educational attainment.	60 Participants n=275 Participants • One participant was missing information on educational attainment.	268 Participants n=1208 Participants • One participant was missing information on educational attainment.
Annual Household Income Less than 20K	141 Participants n=342 Participants	139 Participants n=260 Participants	146 Participants n=332 Participants	121 Participants n=275 Participants	547 Participants n=1209 Participants
Annual Household Income Greater thank 20K	148 Participants n=342 Participants	84 Participants n=260 Participants	138 Participants n=332 Participants	117 Participants n=275 Participants	487 Participants n=1209 Participants
Annual Household Income Declined/Don't know	53 Participants n=342 Participants	37 Participants n=260 Participants	48 Participants n=332 Participants	37 Participants n=275 Participants	175 Participants n=1209 Participants
Married	137 Participants n=340 Participants • Some participants are missing information on marital status.	89 Participants n=260 Participants • Some participants are missing information on marital status.	110 Participants n=331 Participants • Some participants are missing information on marital status.	99 Participants n=273 Participants • Some participants are missing information on marital status.	435 Participants n=1204 Participants • Some participants are missing information on marital status.
Without Health Insurance	51 Participants n=342 Participants	56 Participants n=260 Participants	52 Participants n=332 Participants	35 Participants n=275 Participants	194 Participants n=1209 Participants
Has Diabetes	160 Participants n=342 Participants	123 Participants n=260 Participants	161 Participants n=332 Participants	124 Participants n=275 Participants	568 Participants n=1209 Participants
History of Stroke	28 Participants n=342 Participants	27 Participants n=260 Participants	32 Participants n=332 Participants	24 Participants n=275 Participants	111 Participants n=1209 Participants
General Self-Reported Health Excellent	6 Participants n=342 Participants	5 Participants n=260 Participants	7 Participants n=332 Participants	3 Participants n=275 Participants	21 Participants n=1209 Participants
General Self-Reported Health Very Good	45 Participants n=342 Participants	28 Participants n=260 Participants	41 Participants n=332 Participants	44 Participants n=275 Participants	158 Participants n=1209 Participants
General Self-Reported Health Good	141 Participants n=342 Participants	97 Participants n=260 Participants	128 Participants n=332 Participants	98 Participants n=275 Participants	464 Participants n=1209 Participants
General Self-Reported Health Fair	128 Participants n=342 Participants	101 Participants n=260 Participants	134 Participants n=332 Participants	106 Participants n=275 Participants	469 Participants n=1209 Participants
General Self-Reported Health Poor	22 Participants n=342 Participants	29 Participants n=260 Participants	22 Participants n=332 Participants	24 Participants n=275 Participants	97 Participants n=1209 Participants
Moderate to severe depression (PHQ-8 score >10)	53 Participants n=342 Participants • Some participants are missing information on depressive symptoms.	59 Participants n=259 Participants • Some participants are missing information on depressive symptoms.	89 Participants n=331 Participants • Some participants are missing information on depressive symptoms.	52 Participants n=275 Participants • Some participants are missing information on depressive symptoms.	253 Participants n=1207 Participants • Some participants are missing information on depressive symptoms.
Someone helps read written materials from the doctor a little to all of the time	132 Participants n=342 Participants • Some participants were missing information on health literacy.	120 Participants n=259 Participants • Some participants were missing information on health literacy.	109 Participants n=331 Participants • Some participants were missing information on health literacy.	94 Participants n=273 Participants • Some participants were missing information on health literacy.	455 Participants n=1205 Participants • Some participants were missing information on health literacy.
Problems learning about conditions because can't understand written info.	123 Participants n=341 Participants • Some participants were missing information on health literacy	132 Participants n=258 Participants • Some participants were missing information on health literacy	121 Participants n=329 Participants • Some participants were missing information on health literacy	99 Participants n=274 Participants • Some participants were missing information on health literacy	475 Participants n=1202 Participants • Some participants were missing information on health literacy
Reported greater than 1 barrier to medication adherence	262 Participants n=334 Participants • Some participants are missing information on barriers to medication adherence.	212 Participants n=259 Participants • Some participants are missing information on barriers to medication adherence.	262 Participants n=322 Participants • Some participants are missing information on barriers to medication adherence.	225 Participants n=269 Participants • Some participants are missing information on barriers to medication adherence.	961 Participants n=1184 Participants • Some participants are missing information on barriers to medication adherence.
Social Isolation score (PROMIS)	43 score on a scale n=340 Participants • Some participants are missing information on social isolation	48 score on a scale n=254 Participants • Some participants are missing information on social isolation	48 score on a scale n=328 Participants • Some participants are missing information on social isolation	43 score on a scale n=274 Participants • Some participants are missing information on social isolation	46 score on a scale n=1196 Participants • Some participants are missing information on social isolation
Baseline perceived emotional support score (PROMIS)	62 score on a scale n=341 Participants • Participants were missing information on perceived emotional support	53 score on a scale n=259 Participants • Participants were missing information on perceived emotional support	53 score on a scale n=331 Participants • Participants were missing information on perceived emotional support	62 score on a scale n=275 Participants • Participants were missing information on perceived emotional support	56 score on a scale n=1206 Participants • Participants were missing information on perceived emotional support
Perceived Instrumental Support score (PROMIS)	63 score on a scale n=337 Participants • Some participants were missing information on perceived instrumental support	54 score on a scale n=256 Participants • Some participants were missing information on perceived instrumental support	63 score on a scale n=325 Participants • Some participants were missing information on perceived instrumental support	63 score on a scale n=270 Participants • Some participants were missing information on perceived instrumental support	63 score on a scale n=1188 Participants • Some participants were missing information on perceived instrumental support
Perceived Stress Scale	4 score on a scale n=336 Participants • Some participants were missing information on stress	6 score on a scale n=256 Participants • Some participants were missing information on stress	6 score on a scale n=330 Participants • Some participants were missing information on stress	5 score on a scale n=274 Participants • Some participants were missing information on stress	5 score on a scale n=1196 Participants • Some participants were missing information on stress
Patient Assessment of Chronic Illness Care (PACIC)	3 score on a scale STANDARD_DEVIATION 1 • n=318 Participants • Some participants are missing information on the PACIC	3 score on a scale STANDARD_DEVIATION 1 • n=243 Participants • Some participants are missing information on the PACIC	3 score on a scale STANDARD_DEVIATION 1 • n=317 Participants • Some participants are missing information on the PACIC	3 score on a scale STANDARD_DEVIATION 1 • n=261 Participants • Some participants are missing information on the PACIC	3 score on a scale STANDARD_DEVIATION 1 • n=1139 Participants • Some participants are missing information on the PACIC

PRIMARY outcome

Timeframe: 12 months

Population: There are 4 arms in this study. Arm one is enhanced usual care. Arm 2 is practice facilitation. Arm 3 is peer coaching. In arm 4 practices received practice facilitation and participants peer coaching. Numbers will be different from final numbers in flow diagram because final sample includes participants that had 6 month or 12 month BP data.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=309 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=241 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=309 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=254 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Number of Participants With Blood Pressure Control (Systolic Pressure Less Than 140 mm Hg and Diastolic Pressure Less Than 90 mm Hg) at 12 Months	112 participants	87 participants	130 participants	92 participants

SECONDARY outcome

Timeframe: 12 months

Change in systolic blood pressure between baseline and 12 months, which is analyzed by subtracting the baseline systolic BP from the 12 month systolic BP.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=309 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=241 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=309 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=254 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Systolic Blood Pressure Between Baseline and 12 Months	-11 mm Hg Standard Deviation 23	-10 mm Hg Standard Deviation 24	-11 mm Hg Standard Deviation 21	-12 mm Hg Standard Deviation 22

SECONDARY outcome

Timeframe: 12 months

Patient Assessment of Care for Chronic Conditions (PACIC) measures how patients perceive their chronic condition(s) are being managed by their health care team. Patients fill out a survey of 20 questions regarding the care of their chronic condition(s) over the last 12 months. Used a Likert scale from 1-5, where 1 signifies "None of the time" and 5 signifying "Always". PACIC was scored by summing participants' responses across all 20 items then dividing by 20. This score was calculated at baseline and 12 months follow-up. A change in score for each participant was created by subtracting the 12 months follow-up PACIC score from the baseline PACIC score.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=282 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=223 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=301 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=231 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Satisfaction With Chronic Illness Care Between Baseline and 12 Months	0 score on a scale Standard Deviation 1	0 score on a scale Standard Deviation 1	0 score on a scale Standard Deviation 1	0 score on a scale Standard Deviation 1

SECONDARY outcome

Timeframe: 12 months

Change in health related quality of life measured using self report scale Short form-12. Six questions comprise the PCS. Of the six questions, one question ranges on a 5 point Likert scale from excellent to poor. Two questions range on a 3 point Likert scale from a lot to not at all. Two questions are dichotomous as yes or no. One question ranges on a 5 point Likert scale from extremely to not at all. Different weights are applied to each item to results in scores ranging from 0-100 with higher scores indicating higher functioning.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=314 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=238 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=312 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=251 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Physical Component Summary Score (PCS) of the Short Form 12 (SF12)	2 score on a scale Standard Deviation 9	1 score on a scale Standard Deviation 9	2 score on a scale Standard Deviation 9	2 score on a scale Standard Deviation 10

SECONDARY outcome

Timeframe: 12 months

Change in health related quality of life measured using self report scale Short form-12. Six questions comprise the MCS. Of the six questions, two questions are dichotomous as yes or no. One question ranges on a 5 point Likert scale from all of the time to none of the time. Three questions range on a 6 point Likert scale from all of the time to none of the time. Different weights are applied to each item to result in a score ranging from 0-100 with higher scores indicating higher mental functioning.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=314 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=238 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=312 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=251 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in the Mental Component Summary Score (MCS) From the Short Form 12 (SF12)	3 score on a scale Standard Deviation 11	2 score on a scale Standard Deviation 11	3 score on a scale Standard Deviation 12	3 score on a scale Standard Deviation 12

SECONDARY outcome

Timeframe: between baseline and 6 months

Outcome was defined by self-reported question (yes/no) or chart review. Those who reported yes to the question, "In the past 6 months have you been seen in an ER/ED but not admitted overnight" were considered having the outcome. Data collectors looked for ED visits in patient's charts between baseline and 6 month visit. The outcome measure timeframe is between baseline and 6 months.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=334 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=252 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=319 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=269 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Self-reported ED Visit or Evidence of an ED Visit at Chart Review Between Baseline and 6 Months	90 participants	53 participants	77 participants	65 participants

SECONDARY outcome

Timeframe: between 6 months to 12 month

Outcome was defined by self-reported question (yes/no) or chart review. Those who reported yes to the question, "In the past 6 months have you been seen in an ER/ED but not admitted overnight" were considered having the outcome. Data collectors looked for ED visits in patient's charts between their 6 month and 12 month follow-up. The outcome measure timeframe is between 6 months and 12 month follow-up.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=322 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=246 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=321 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=262 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Self-reported ED Visit or Evidence of an ED Visit in Chart Review Between 6 Months and 12 Months	78 participants	59 participants	66 participants	55 participants

SECONDARY outcome

Timeframe: between baseline to 6 months

Outcome was defined by self-reported question (yes/no) or chart review. Those who reported yes to the question, "In the past 6 months have you been hospitalized overnight?" were considered having the outcome. Data collectors looked for hospitalization in patient's charts between baseline and 6 month visit. The outcome measure timeframe is between baseline and 6 months.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=334 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=252 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=319 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=269 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Self-reported Hospitalization or Evidence of Hospitalization in Chart Review Between Baseline and 6 Months	32 participants	29 participants	32 participants	28 participants

SECONDARY outcome

Timeframe: between 6 month to 12 month

Outcome was defined by self-reported question (yes/no) or chart review. Those who reported yes to the question, "In the past 6 months have you been hospitalized overnight?" were considered having the outcome. Data collectors looked for hospitalizations in patient's charts between their 6 month and 12 month follow-up. The outcome measure timeframe is between 6 months and 12 month follow-up.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=322 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=246 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=321 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=262 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Self-Reported Hospitalization or Evidence of Hospitalization in Chart Review Between 6 Month and 12 Month	24 participants	35 participants	32 participants	30 participants

SECONDARY outcome

Timeframe: 12 months

The 4-item Cohen perceived stress scale that are measured on a 5-point scale (0 = never, 1= almost never, 2 = sometimes, 3 = fairly often and 4- very often). Items 2 and 3 are reverse coded and then all for items are summed to created a total score that ranges from 0 -16. A higher score is negative indicating greater perceived stress.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=314 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=240 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=316 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=251 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Perceived Stress	0 score on a scale Standard Deviation 3	-1 score on a scale Standard Deviation 4	-1 score on a scale Standard Deviation 4	-1 score on a scale Standard Deviation 4

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 months

Self-reported stroke was defined as participants reporting yes to the question: Since the last time we spoke, were you ever told by a physician that you had a stroke?

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=320 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=243 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=319 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=254 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Self-reported Stroke	6 participants	14 participants	5 participants	4 participants

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 months

We measured change in perceived instrumental support between baseline and 12 months using the Patient Reported Outcomes Measurement Information System (PROMIS) short-form social functioning scale. To each question subjects were asked to respond with "never," "rarely," "sometimes," "usually," or "always." A numerical value was attached to each of these answers, ranging from 1 ("never") to 5 ("always"). Raw scores were translated to standardized t-scores to allow comparison of our sample to the U.S population. "). The T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. Raw scores ranged from 4-20. Scale scores ranged from 29.3-69.3 with a higher score indicating greater instrumental support.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=313 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=242 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=311 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=250 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Instrumental Support	0 T score Standard Deviation 8	2 T score Standard Deviation 9	1 T score Standard Deviation 10	1 T score Standard Deviation 8

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 months

We measured change perceived emotional support between baseline and 12 months using the Patient Reported Outcomes Measurement Information System (PROMIS) short-form social functioning scale. To each question subjects were asked to respond with "never," "rarely," "sometimes," "usually," or "always." A numerical value was attached to each of these answers, ranging from 1 ("never") to 5 ("always"). The T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. Raw scores were translated to standardized t-scores to allow comparison of our sample to the U.S population. Raw scores ranged from 4-20 and scale scores ranged from 25.7-62 with higher scores indicating greater emotional support.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=317 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=244 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=316 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=253 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Perceived Emotional Support	0 T score Standard Deviation 8	2 T score Standard Deviation 9	2 T score Standard Deviation 9	2 T score Standard Deviation 10

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 months

We measured change in isolation between baseline and 12 months using the Social Isolation Patient Reported Outcomes Measurement Information System (PROMIS) short-form social functioning scale. To each question subjects were asked to respond with "never," "rarely," "sometimes," "usually," or "always." A numerical value was attached to each of these answers, ranging from 1 ("never") to 5 ("always"). Raw scores were translated to standardized t-scores to allow comparison of our sample to the U.S population. The T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. The scale is comprised of 4 items. Raw scores range from 0-20 and scale scores range from 34.8-74.2. Higher scores indicate greater isolation.

Outcome measures

Outcome measures
Measure	Enhanced Usual Care n=316 Participants Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=236 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=311 Participants Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=250 Participants Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Change in Social Isolation	-1 T score Standard Deviation 9	-2 T score Standard Deviation 10	-2 T score Standard Deviation 10	-1 T score Standard Deviation 10

Adverse Events

Enhanced Usual Care

Serious events: 177 serious events

Other events: 66 other events

Deaths: 2 deaths

Practice Facilitation

Serious events: 152 serious events

Other events: 62 other events

Deaths: 0 deaths

Peer Coach

Serious events: 162 serious events

Other events: 63 other events

Deaths: 5 deaths

Peer Coach and Practice Facilitation

Serious events: 148 serious events

Other events: 41 other events

Deaths: 7 deaths

Serious adverse events

Serious adverse events
Measure	Enhanced Usual Care n=342 participants at risk Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=283 participants at risk Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=330 participants at risk Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=285 participants at risk Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
Cardiac disorders Hypotension	5.6% 19/342 • Number of events 20 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	3.2% 9/283 • Number of events 10 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	5.8% 19/330 • Number of events 20 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	6.3% 18/285 • Number of events 18 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.
General disorders Any ED Visit	31.6% 108/342 • Number of events 155 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	28.6% 81/283 • Number of events 120 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	31.8% 105/330 • Number of events 155 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	29.8% 85/285 • Number of events 132 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.
General disorders Any hospitalization	13.2% 45/342 • Number of events 63 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	15.5% 44/283 • Number of events 57 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	15.8% 52/330 • Number of events 64 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	14.4% 41/285 • Number of events 50 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.
General disorders Self reported falls with Ed visit	2.0% 7/342 • Number of events 8 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	5.3% 15/283 • Number of events 16 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	2.4% 8/330 • Number of events 8 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	1.8% 5/285 • Number of events 7 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.
General disorders Self reported stroke	4.1% 14/342 • Number of events 16 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	8.5% 24/283 • Number of events 28 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	2.4% 8/330 • Number of events 10 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	4.2% 12/285 • Number of events 14 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.
Cardiac disorders Hypertension	16.1% 55/342 • Number of events 66 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	19.1% 54/283 • Number of events 66 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	11.2% 37/330 • Number of events 41 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	15.4% 44/285 • Number of events 49 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.

Other adverse events

Other adverse events
Measure	Enhanced Usual Care n=342 participants at risk Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Practice Facilitation n=283 participants at risk Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach n=330 participants at risk Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.	Peer Coach and Practice Facilitation n=285 participants at risk Practices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. The patients will also be matched with peer advisors who will work with the participants for 12 months. Practice Facilitation: ractices that are randomized to the practice facilitation arm will work with a practice facilitator that will help practice staff for 15 months to make practice level changes to improve hypertension control. Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction Peer Coach: Participants enrolled from practices that are randomized to the peer coach arm will be matched with peer advisors who will work with the participants for 12 months. Enhanced usual care: Practices in the usual enhanced care arm will receive a blood pressure medication algorithm developed using national guidelines and content experts on our study team. Practices will be provided the Joint National Committee (JNC) recommended protocol to measuring blood pressures. Practices will receive a laptop workstation that has access to the Patient Activated Learning System - an online education video system.
General disorders Self reported dizziness upon standing or fainting	6.4% 22/342 • Number of events 23 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	10.2% 29/283 • Number of events 34 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	9.4% 31/330 • Number of events 33 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	9.1% 26/285 • Number of events 27 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.
General disorders Self reported falls that did not result in an ED visit	13.7% 47/342 • Number of events 56 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	15.2% 43/283 • Number of events 52 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	12.1% 40/330 • Number of events 53 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.	7.0% 20/285 • Number of events 23 • 1 year Sample for serious and non-serious adverse events includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits. Sample for all-cause mortality includes only enrolled participants with follow-up data (6 or 12 month data) on blood pressure, chart review, self-reported sides effects and self-reported hospitalizations/ED visits OR have an adverse events form.

Additional Information

Dr. Andrea Cherrington

University of Alabama at Birmingham

Phone: 205-996-2885

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place