Impact of Computerized Decision Support on Racial/Ethnic Disparities in Hypertension Outcomes

The recruitment status of this study is unknown because the information has not been verified recently.
Verified June 2011 by Brigham and Women's Hospital.
Recruitment status was  Active, not recruiting
Sponsor:
Collaborator:
Robert Wood Johnson Foundation
Information provided by:
Brigham and Women's Hospital
ClinicalTrials.gov Identifier:
NCT01083940
First received: March 8, 2010
Last updated: June 22, 2011
Last verified: June 2011
  Purpose

In response to the Finding Answers: Disparities Research for Change call for proposals by the Robert Wood Johnson Foundation, we were funded to evaluate the effectiveness of a planned computerized decision support (CDS) intervention aimed at medical providers to overcome clinical inertia when treating blood pressure for hypertensive patients. Based on prior evaluation of the Brigham and Women's Hospital (BWH) adult primary care clinics, we hypothesize that racial and ethnic differences in blood pressure outcomes are largely attributable in differences in providers' aggressiveness in managing patients with hypertension based on patients' race and ethnicity. Within our network of 14 hospital and community-based Brigham and Women's Hospital adult primary care clinics, we aim to determine if the use of CDS to remind to medical providers of poorly controlled hypertensive patients to intensify their hypertension therapy will improve overall rates of blood pressure control and reduce the previously documented racial and ethnic disparities in blood pressure outcomes among our hypertensive patient population. Clinics will first be stratified by location (hospital-based versus community-based) and within each strata will be randomized to either have their providers receive CDS for hypertensive patients whose most recent blood pressure was uncontrolled or to usual care for hypertensive patients. More specifically, we will evaluate our planned intervention by utilizing an 18 month cluster-randomized controlled trial to examine the effectiveness the CDS for intensification of hypertension therapy in: improving levels of blood pressure control, improving provider adherence with recommended changes in drug therapy, and reducing racial/ethnic disparities in the processes of hypertension care and outcomes among our patients receiving primary care for a diagnosis of hypertension.


Condition Intervention Phase
Hypertension
Other: Computerized reminders on hypertension intensification
Phase 0

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Single Blind (Subject)
Primary Purpose: Health Services Research
Official Title: Evaluating the Impact of Computerized Decision Support on Racial/Ethnic Disparities in Hypertension Outcomes

Resource links provided by NLM:


Further study details as provided by Brigham and Women's Hospital:

Primary Outcome Measures:
  • Rate of blood pressure control at outcome between study arms [ Time Frame: 10/1/2010-10/1/2011 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Rate of appropriate intensification of antihypertensive therapy [ Time Frame: 10/2010-7/2011 ] [ Designated as safety issue: No ]

Estimated Enrollment: 3600
Study Start Date: October 2010
Estimated Study Completion Date: October 2011
Estimated Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Reminders to providers Other: Computerized reminders on hypertension intensification
Reminder generated to prompt providers to intensify therapy when patient's blood pressure remains uncontrolled
No Intervention: usual care

  Eligibility

Ages Eligible for Study:   20 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Adult patients (> 20 years) with ICD-9 of hypertension with a minimum of 2 outpatient primary care visits in from 10/2008-10/2009 who receive care for hypertension in the outpatient practices at least once for hypertension from 10/2009-7/2001

Exclusion Criteria:

  • Pregnancy, age < 20 years, fewer than two hypertension-related visits from 10/2008-10/2009
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01083940

Locations
United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02120
Sponsors and Collaborators
Brigham and Women's Hospital
Robert Wood Johnson Foundation
  More Information

No publications provided

Responsible Party: LeRoi Hicks, MD, MPH, Brigham and Women's Hospital
ClinicalTrials.gov Identifier: NCT01083940     History of Changes
Other Study ID Numbers: 66708
Study First Received: March 8, 2010
Last Updated: June 22, 2011
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Hypertension
Vascular Diseases
Cardiovascular Diseases

ClinicalTrials.gov processed this record on August 20, 2014