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

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified June 2011 by Brigham and Women's Hospital.
Recruitment status was:  Active, not recruiting
Robert Wood Johnson Foundation
Information provided by:
Brigham and Women's Hospital Identifier:
First received: March 8, 2010
Last updated: June 22, 2011
Last verified: June 2011
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 Early Phase 1

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

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 ]

Secondary Outcome Measures:
  • Rate of appropriate intensification of antihypertensive therapy [ Time Frame: 10/2010-7/2011 ]

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


Ages Eligible for Study:   20 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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
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Please refer to this study by its identifier: NCT01083940

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

Responsible Party: LeRoi Hicks, MD, MPH, Brigham and Women's Hospital Identifier: NCT01083940     History of Changes
Other Study ID Numbers: 66708
Study First Received: March 8, 2010
Last Updated: June 22, 2011

Additional relevant MeSH terms:
Vascular Diseases
Cardiovascular Diseases processed this record on September 21, 2017