Improving Hypertension Management Through Preference List Defaults
NCT ID: NCT07298694
Last Updated: 2025-12-23
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
NA
12150 participants
INTERVENTIONAL
2026-01-31
2026-04-30
Brief Summary
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Detailed Description
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This intervention works by adding a special character ( i.e., "(" ) to the beginning of a medication name in EPIC, which moves it to the top of the preference list. However, this only works when the provider searches for the first medication in a combination medication. For example, if a provider in the intervention group searches for "Amlodipine," the combination "(PREFERRED) Amlodipine-Benazepril" will appear at the top of the preference list.
However, a special character is NOT prioritized in the preference list when the second medication in a combination medication name is searched. For example, if the provider searches "Benazepril," the combination "(PREFERRED) Amlodipine-Benazepril" will be shown after single-class Benazepril prescriptions. The "(PREFERRED)" prefix will still be shown, which may encourage prescribing even without the medication listed first.
The study will employ a three-level hierarchical design, clustering patients within providers and providers within clinics. The study will run for 3 months or until enrollment reaches 12,150 unique patients, whichever comes second.
Clinic randomization will be stratified by variables that may affect response to the intervention including: clinic type (community medicine, senior medicine, internal medicine, FQHC), baseline prescribing rate for combination medications (\<8%, 8%-13%, \>13%), and number of providers (1-4, 5-9, 10-29, 30+).
One exception to the above stratification is internal medicine, where there are only two clinics. These are also the only two clinics with 30+ providers, but baseline combination medication prescribing rates fall in different stratification categories. These two clinics will be kept in the same stratum because they are still similar in culture, procedures, and size.
Stratified randomization was simulated 1000 times. Because strata are randomized independently and some strata include uneven numbers of clinics, overall assignment of the 50 clinics to treatment and control was uneven (e.g., 26 in treatment and 24 in control) on 709 of the 1000 iterations. To ensure a balance in clinic allocation to study arms, one of the 291 evenly randomized iterations will be randomly selected for implementation in the study.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Revised Preference List
"(PREFERRED)" will be added to the beginning of the preference list for selected BP medications, which will frequently cause these medications to be listed first.
Revising preference list by adding "(PREFERRED)" to combination medication names
Providers in the intervention group will see "(PREFERRED)" listed before combination blood pressure medication names, which will frequently cause the combination medications to appear at the top of the EHR preference list.
No Change to the Preference List
Clinics will retain the usual EHR preference list order, with no changes to the default medication display.
No interventions assigned to this group
Interventions
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Revising preference list by adding "(PREFERRED)" to combination medication names
Providers in the intervention group will see "(PREFERRED)" listed before combination blood pressure medication names, which will frequently cause the combination medications to appear at the top of the EHR preference list.
Eligibility Criteria
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Inclusion Criteria
* The order is placed at an in-person, virtual (telemed), telephone, or nurse encounter in a clinic included in the study
* Patient is age 18+
* Order is placed in the clinician's primary clinic
Exclusion Criterion:
\- Order was placed by a clinical leader who was aware of the study
18 Years
ALL
No
Sponsors
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Geisinger Clinic
OTHER
Responsible Party
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Gail Rosenbaum
Principal Investigator
Central Contacts
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Other Identifiers
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2025-0593
Identifier Type: -
Identifier Source: org_study_id