Trial Outcomes & Findings for Pragmatic Trial Comparing Telehealth Care and Optimized Clinic-Based Care for Uncontrolled High Blood Pressure (NCT NCT02996565)
NCT ID: NCT02996565
Last Updated: 2024-09-23
Results Overview
Change in systolic BP, collected from medical records
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
3071 participants
Primary outcome timeframe
Trajectory over 12 months
Results posted on
2024-09-23
Participant Flow
Participants were screened and enrolled during primary care encounters at eligible and randomized primary care clinics in a large integrated health system. Patients were enrolled between November 15, 2017 and April 15, 2019.
Among 57 primary care clinics screened for eligibility, 36 were excluded (16 no MTM; 20 not using automated BP monitor) and 21 were randomized (17 individual clinics plus 4 clinics as 2 co-located pairs). Among 69,480 patients screened in primary care encounters, 3,071 met all inclusion criteria and were enrolled in the study and received care according to the clinic-randomized treatment arm.
Unit of analysis: Primary Care Clinics
Participant milestones
| Measure |
Best Practice Clinic-Based Care
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Overall Study
STARTED
|
1648 9
|
1423 10
|
|
Overall Study
Referred to Intended Provider for Hypertension Follow-up
|
1480 9
|
1060 10
|
|
Overall Study
Attended Follow-up Within 6 Weeks (With Any Provider Type)
|
890 9
|
887 10
|
|
Overall Study
Attended Follow-up Within 6 Weeks (With Intended Provider)
|
532 9
|
385 10
|
|
Overall Study
COMPLETED
|
532 9
|
275 10
|
|
Overall Study
NOT COMPLETED
|
1116 0
|
1148 0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Data available for baseline survey respondents only
Baseline characteristics by cohort
| Measure |
Best Practice Clinic-Based Care
n=1648 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=1423 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
Total
n=3071 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
58.3 years
STANDARD_DEVIATION 14.2 • n=1648 Participants
|
62.4 years
STANDARD_DEVIATION 14.2 • n=1423 Participants
|
60.2 years
STANDARD_DEVIATION 14.4 • n=3071 Participants
|
|
Sex: Female, Male
Female
|
834 Participants
n=1648 Participants
|
805 Participants
n=1423 Participants
|
1639 Participants
n=3071 Participants
|
|
Sex: Female, Male
Male
|
814 Participants
n=1648 Participants
|
618 Participants
n=1423 Participants
|
1432 Participants
n=3071 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
46 Participants
n=1648 Participants
|
14 Participants
n=1423 Participants
|
60 Participants
n=3071 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
1585 Participants
n=1648 Participants
|
1386 Participants
n=1423 Participants
|
2971 Participants
n=3071 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
17 Participants
n=1648 Participants
|
23 Participants
n=1423 Participants
|
40 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
15 Participants
n=1648 Participants
|
4 Participants
n=1423 Participants
|
19 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
Asian
|
92 Participants
n=1648 Participants
|
121 Participants
n=1423 Participants
|
213 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
1 Participants
n=1648 Participants
|
2 Participants
n=1423 Participants
|
3 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
Black or African American
|
329 Participants
n=1648 Participants
|
265 Participants
n=1423 Participants
|
594 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
White
|
1144 Participants
n=1648 Participants
|
988 Participants
n=1423 Participants
|
2132 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
More than one race
|
8 Participants
n=1648 Participants
|
7 Participants
n=1423 Participants
|
15 Participants
n=3071 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
59 Participants
n=1648 Participants
|
36 Participants
n=1423 Participants
|
95 Participants
n=3071 Participants
|
|
Highest education level
High school, GED, or less
|
316 Participants
n=908 Participants • Data available for baseline survey respondents only
|
247 Participants
n=780 Participants • Data available for baseline survey respondents only
|
563 Participants
n=1688 Participants • Data available for baseline survey respondents only
|
|
Highest education level
Some college or technical school
|
315 Participants
n=908 Participants • Data available for baseline survey respondents only
|
284 Participants
n=780 Participants • Data available for baseline survey respondents only
|
599 Participants
n=1688 Participants • Data available for baseline survey respondents only
|
|
Highest education level
4-year college degree
|
171 Participants
n=908 Participants • Data available for baseline survey respondents only
|
137 Participants
n=780 Participants • Data available for baseline survey respondents only
|
308 Participants
n=1688 Participants • Data available for baseline survey respondents only
|
|
Highest education level
>4-year college degree
|
106 Participants
n=908 Participants • Data available for baseline survey respondents only
|
112 Participants
n=780 Participants • Data available for baseline survey respondents only
|
218 Participants
n=1688 Participants • Data available for baseline survey respondents only
|
|
Employment
Full-time
|
351 Participants
n=908 Participants • Data available for baseline survey respondents only
|
231 Participants
n=785 Participants • Data available for baseline survey respondents only
|
582 Participants
n=1693 Participants • Data available for baseline survey respondents only
|
|
Employment
Part-time
|
71 Participants
n=908 Participants • Data available for baseline survey respondents only
|
68 Participants
n=785 Participants • Data available for baseline survey respondents only
|
139 Participants
n=1693 Participants • Data available for baseline survey respondents only
|
|
Employment
Retired
|
332 Participants
n=908 Participants • Data available for baseline survey respondents only
|
350 Participants
n=785 Participants • Data available for baseline survey respondents only
|
682 Participants
n=1693 Participants • Data available for baseline survey respondents only
|
|
Employment
Otherwise not working for pay
|
154 Participants
n=908 Participants • Data available for baseline survey respondents only
|
136 Participants
n=785 Participants • Data available for baseline survey respondents only
|
290 Participants
n=1693 Participants • Data available for baseline survey respondents only
|
|
Annual Income
Less than $20,000
|
164 Participants
n=798 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
143 Participants
n=683 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
307 Participants
n=1481 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
|
Annual Income
$20,000 to $49,999
|
258 Participants
n=798 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
185 Participants
n=683 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
443 Participants
n=1481 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
|
Annual Income
$50,000 to $99,999
|
231 Participants
n=798 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
238 Participants
n=683 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
469 Participants
n=1481 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
|
Annual Income
Greater than or equal to $100,000
|
145 Participants
n=798 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
117 Participants
n=683 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
262 Participants
n=1481 Participants • Measure Analysis Population Description: Data available for baseline survey respondents only
|
|
Systolic Blood Pressure (SBP)
|
157.4 mm Hg
STANDARD_DEVIATION 15.4 • n=1648 Participants
|
158.8 mm Hg
STANDARD_DEVIATION 15.2 • n=1423 Participants
|
158.0 mm Hg
STANDARD_DEVIATION 15.3 • n=3071 Participants
|
|
Diastolic Blood Pressure (DBP)
|
93.1 mm Hg
STANDARD_DEVIATION 13.8 • n=1648 Participants
|
90.0 mm Hg
STANDARD_DEVIATION 13.8 • n=1423 Participants
|
91.7 mm Hg
STANDARD_DEVIATION 13.9 • n=3071 Participants
|
|
Number of anti-hypertensive medication classes
|
1.7 anti-hypertensive medication classes
STANDARD_DEVIATION 1.1 • n=1648 Participants
|
1.7 anti-hypertensive medication classes
STANDARD_DEVIATION 1.2 • n=1423 Participants
|
1.7 anti-hypertensive medication classes
STANDARD_DEVIATION 1.1 • n=3071 Participants
|
|
Body Mass Index (BMI) greater than or equal to 30
|
987 Participants
n=1648 Participants
|
743 Participants
n=1423 Participants
|
1730 Participants
n=3071 Participants
|
|
Diabetes
|
407 Participants
n=1648 Participants
|
366 Participants
n=1423 Participants
|
773 Participants
n=3071 Participants
|
|
Cardiovascular disease
|
247 Participants
n=1648 Participants
|
265 Participants
n=1423 Participants
|
512 Participants
n=3071 Participants
|
PRIMARY outcome
Timeframe: Trajectory over 12 monthsChange in systolic BP, collected from medical records
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=1648 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=1423 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Change in Systolic Blood Pressure Between Baseline and 12 Months (mm Hg)
|
-17.97 mm Hg
Interval -19.43 to -16.5
|
-18.72 mm Hg
Interval -20.2 to -17.24
|
SECONDARY outcome
Timeframe: Trajectory over 12 monthschange in diastolic BP, collected from medical records
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=1648 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=1423 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Change in Diastolic BP Between Baseline and 12 Months (mm Hg)
|
-9.98 mm Hg
Interval -10.84 to -9.11
|
-9.70 mm Hg
Interval -10.58 to -8.83
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report of monitoring BP at least 2 times per week
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=673 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=603 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Reporting Monitoring BP at Least 2 Times Per Week at Six Months Follow-up
|
189 Participants
|
265 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient rating of 9-10 vs. 0-8 on a scale of 0 (low satisfaction) to 10 (high satisfaction). Developed from a scale used by Green, et al (2008). Citation: Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, Carrell D,Tyll L, Larson EB, Thompson RS. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA. 2008;299:2857-2867. doi:10.1001/jama.299.24.2857
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=678 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=610 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Report High Level of Satisfaction With Hypertension Care at Six Months.
|
205 Participants
|
241 Participants
|
SECONDARY outcome
Timeframe: Baseline to 12 monthsPopulation: The numbers of participants analyzed represent the number of participants with smoking status available in the EHR
Current smoker at 12 months
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=302 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=218 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Are Current Smokers at Twelve Months
|
273 Participants
|
199 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that side effect is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=656 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=593 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Cough as a Side Effect of Antihypertensive Medications at Six Months
|
202 Participants
|
212 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that side effect is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=656 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=593 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Dizziness as a Side Effect of Antihypertensive Medication at Six Months
|
247 Participants
|
232 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that side effect is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=656 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=593 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Frequent Urination as a Side Effect of Antihypertensive Medication at Six Months
|
331 Participants
|
293 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that side effect is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=656 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=593 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Leg/Foot Swelling as a Side Effect of Antihypertensive Medication at Six Months
|
247 Participants
|
208 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that side effect is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=656 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=593 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Sexual Symptoms as a Side Effect of Antihypertensive Medication at Six Months
|
174 Participants
|
132 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that side effect is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=656 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=593 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Tiredness as a Side Effect of Antihypertensive Medication at Six Months
|
437 Participants
|
376 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that activity is helpful for BP self-management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=538 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=471 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Report Decreasing Salt as Helpful for BP Self-management at Six Months
|
274 Participants
|
242 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that activity is helpful for BP self-management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=339 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=289 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Report Limiting Alcohol as Helpful for BP Self-management at Six Months
|
147 Participants
|
138 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that activity is helpful for BP self management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=560 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=506 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Report Physical Activity as Helpful for BP Self-management at Six Months
|
291 Participants
|
256 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that activity is helpful for BP self management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=566 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=482 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Report Reducing Stress as Helpful for BP Self-management at Six Months
|
278 Participants
|
243 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that activity is helpful for BP self management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=556 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=488 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Who Report Watching Weight as Helpful for BP Self-management at Six Months
|
290 Participants
|
249 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=632 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=578 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Identifying Clinic Visits as BP Care Burden at Six Months
|
196 Participants
|
149 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=649 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=588 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Identifying Cost of Care or Medications as BP Care Burden at Six Months
|
188 Participants
|
134 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=615 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=552 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Increasing Physical Activity as BP Care Burden at Six Months
|
236 Participants
|
242 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=601 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=529 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Lifestyle Changes as BP Care Burden at Six Months
|
251 Participants
|
192 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=587 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=558 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Measuring BP as BP Care Burden at Six Months
|
158 Participants
|
164 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=479 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=481 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Phone Visits as BP Care Burden at Six Months
|
94 Participants
|
66 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=639 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=579 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Scheduling Visits as BP Care Burden at Six Months
|
186 Participants
|
127 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient report that burden is a problem
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=590 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=531 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting Time Away From Work as BP Care Burden at Six Months
|
159 Participants
|
92 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient reported "very" or "extremely" confident in this aspect of BP management.
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=671 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=598 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting High Confidence in Reporting Contacting Care Team at Six Months Confidence in Managing Blood Pressure: Contact Care Team
|
481 Participants
|
467 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item.
Patient reported "very" or "extremely" confident in this aspect of BP management.
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=670 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=599 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting High Confidence in Keeping BP Below Target at Six Months
|
242 Participants
|
252 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item
Patient reported "very" or "extremely" confident in this aspect of BP management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=662 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=594 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting High Confidence in Knowing BP Target Numbers at Six Months
|
437 Participants
|
465 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item
Patient reported "very" or "extremely" confident in this aspect of BP management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=652 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=597 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting High Confidence in Measuring BP at Home at Six Months
|
376 Participants
|
412 Participants
|
SECONDARY outcome
Timeframe: Baseline to 6 monthsPopulation: The numbers of participants analyzed represent the number of survey respondents who answered the specific survey item
Patient reported "very" or "extremely" confident in this aspect of BP management
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=667 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=595 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants Reporting High Confidence in Taking BP Medications at Six Months
|
564 Participants
|
532 Participants
|
SECONDARY outcome
Timeframe: Baseline to 12 monthsNew statin medication current at 12 months
Outcome measures
| Measure |
Best Practice Clinic-Based Care
n=1648 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=1423 Participants
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Number of Participants With Statin Addition at 12 Months
|
162 Participants
|
151 Participants
|
Adverse Events
Best Practice Clinic-Based Care
Serious events: 29 serious events
Other events: 597 other events
Deaths: 42 deaths
Telehealth Care
Serious events: 34 serious events
Other events: 567 other events
Deaths: 43 deaths
Serious adverse events
| Measure |
Best Practice Clinic-Based Care
n=1648 participants at risk；n=1646 participants at risk
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=1422 participants at risk
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Vascular disorders
hypotension
|
1.5%
23/1574 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
1.9%
26/1360 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Metabolism and nutrition disorders
hypokalemia
|
0.13%
2/1510 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
0.08%
1/1294 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Metabolism and nutrition disorders
hyperkalemia
|
0.06%
1/1588 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
0.15%
2/1363 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Metabolism and nutrition disorders
hyponatremia
|
0.20%
3/1535 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
0.48%
6/1262 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
Other adverse events
| Measure |
Best Practice Clinic-Based Care
n=1648 participants at risk；n=1646 participants at risk
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Best Practice Clinic-Based Care intervention.
Best Practice Clinic-Based Care: Relies primarily on the physician-medical assistant dyad and face-to-face visits to promote:
1. Improved recognition of uncontrolled BP at primary care encounters,
2. Therapeutic action to address uncontrolled BP at primary care encounters,
3. Reliable follow-up visits to re-assess uncontrolled BP every 2-4 weeks.
|
Telehealth Care
n=1422 participants at risk
Patients with uncontrolled hypertension who receive primary care in clinics assigned to the Telehealth Care intervention.
Telehealth Care: All elements of Clinic-Based Care are performed, plus a telemonitoring and pharmacist case management program is offered, specifically:
1. Referral to care by MTM pharmacist or Nurse Practitioner and receiving a home blood pressure telemonitoring device
2. Systematic home BP telemonitoring with data transmitted into patient medical record
3. Systematic home-based care by pharmacist or nurse practitioner via telephone and/or secure email
|
|---|---|---|
|
Vascular disorders
hypotension
|
7.6%
119/1574 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
8.7%
118/1360 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Metabolism and nutrition disorders
hypokalemia
|
12.8%
194/1510 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
14.5%
187/1294 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Metabolism and nutrition disorders
hyperkalemia
|
5.5%
87/1588 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
7.7%
105/1363 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Metabolism and nutrition disorders
hyponatremia
|
11.2%
172/1535 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
15.1%
190/1262 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
|
Renal and urinary disorders
abnormal eGFR
|
16.4%
227/1380 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
19.5%
219/1122 • 2 years
AEs were defined by primary diagnosis codes from outpatient, inpatient, or emergency encounters, active problem list entry, or abnormal lab values. SAEs were defined by primary diagnosis codes from inpatient or emergency encounters. AEs and SAEs (hypotension, hypokalemia, hyperkalemia, hyponatremia and abnormal eGFR) were only monitored in those without evidence in the EHR of these conditions in the year prior to study enrollment. The entire study population was monitored for mortality.
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place